脑裂头蚴病的手术疗效分析

Analysis of surgical effect of cerebral sparganosis

目的探讨脑裂头蚴病的手术疗效。方法回顾性分析58例确诊并行手术治疗的脑裂头蚴病病例的临床资料,均显微镜下切开皮质探查病灶、寻找虫体。结果在58例手术病人中,取出虫体45例(取出虫体46条),未取出虫体13例。随访时间6~96个月,取出虫体的45例和未取出虫体的8例均显示病灶强化影消失,脑内其他部位未见新发病灶。另5例未取出虫体者出现新发病灶,提示仍有活虫存留。脑裂头蚴病伴癫痫病例,术后改良Engel分级,两组差异具有统计学意义(P<0.05),表明手术取出虫体对癫痫的疗效优于未取出虫体者。其他症状均未因手术而加重,无死亡病例。结论脑裂头蚴病外科手术治疗安全,完整取出虫体能够获得较好疗效。

Objective To investigate the surgical therapeutic effect of cerebral sparganosis.Methods The clinical data of 58 cases of sparganosis who were diagnosed and treated by surgery were analyzed retrospectively.The cortex was cut under a microscope to explore the lesion and search for sparganosis.Results Among the 58 surgical patients,45 were taken out of the parasites(46 parasites),and 13 cases were not taken out.During the follow-up period of 6 to 96 months,the enhancement of the lesions disappeared in 45 patients with parasites removal and 8 without parasite finding,and no new lesion was found in the brain.The other 5 cases who had not removed the parasites showed new lesions,suggesting that there were still live parasites.For the cases of cerebral sparganosis with epilepsy,the modified Engel classification after operation showed a statistically significant difference between the two groups(P<0.05),indicating that surgical removal of the parasites was more effective for epilepsy than those without parasite removal.No other symptoms were aggravated by surgery,and there was no death.Conclusions The surgical treatment of cerebral sparganosis is safe,and the complete removal of the parasites can achieve better results.