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脑血吸虫病的诊断与治疗:附166例报告

[Diagnosis and treatment of cerebral schistosomiasis: a report of 166 cases].

作者信息

Zhu Fei, Huang Xin, Wu Ming, Jin Wei-Xin, Xie Kui

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2014 Dec;26(6):695-6.

Abstract

OBJECTIVE

To discuss the clinical features, diagnosis and treatment of cerebral schistosomiasis.

METHODS

A total of 166 patients with cerebral schistosomiasis were treated, and their clinical data were collected and analyzed retrospectively.

RESULTS

In 166 cases of cerebral schistosomiasis, the confirmative diagnoses of 156 cases were diagnosed according to the clinical manifestation, etiology, immunology and auxiliary examination (CT, MRI). In among, 74 cases were confirmed by pathological examination, 10 cases were diagnosed through to the diagnostic treatment. Totally 102 patients received the oral medication of praziquantel, and they all improved and discharged 14-16 days later; 64 patients received the craniotomy and praziquantel medication after the operation, and 48 patients significantly improved, others did not improve or aggravated. There was no operative mortality.

CONCLUSIONS

Neuroimaging and laboratory tests are valuable in the diagnosis of cerebral schistosomiasis. The praziquantel treatment is selected firstly when the diagnosis was established. However, in the case of serious intracranial hypertension, intractable epilepsy and praziquantel treatment fails, the surgical treatment is required.

摘要

目的

探讨脑血吸虫病的临床特征、诊断及治疗方法。

方法

对166例脑血吸虫病患者进行治疗,并回顾性收集和分析其临床资料。

结果

166例脑血吸虫病患者中,156例根据临床表现、病因、免疫学及辅助检查(CT、MRI)确诊,其中74例经病理检查确诊,10例经诊断性治疗确诊。102例患者口服吡喹酮治疗,均于14 - 16天后病情改善出院;64例患者行开颅手术并术后服用吡喹酮,48例患者病情明显改善,其余患者无改善或病情加重。无手术死亡病例。

结论

神经影像学检查和实验室检查对脑血吸虫病的诊断有重要价值。确诊后首选吡喹酮治疗,但在颅内高压严重、癫痫难以控制及吡喹酮治疗无效的情况下,需行手术治疗。

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