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83例脑裂头蚴病患者临床资料分析 闫学强
83例脑裂头蚴病患者临床资料分析 闫学强
《中国寄生虫学与寄生虫病杂志》网络首发论文
题目: 83 例脑裂头蚴病患者临床资料分析
作者: 闫学强,李晓龙,孙祯卿,吴杰
收稿日期: 2020-06-27
网络首发日期: 2020-12-08
引用格式: 闫学强,李晓龙,孙祯卿,吴杰.83 例脑裂头蚴病患者临床资料分析[J/OL].中
国寄生虫学与寄生虫病杂志.
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中国寄生虫学与寄生虫病杂志 2020 年 12 月第 38 卷第 6 期 Chin J Parasitol Parasit Dis Dec. 2020袁 Vol. 38袁 No. 6 窑1窑
文章编号院1000鄄7423渊2020冤鄄06鄄0000鄄00 揖论 著铱
83 例脑裂头蚴病患者临床资料分析
闫学强,李晓龙,孙祯卿,吴杰 *
揖 Abstract铱 Objective To analyze the clinical data, treatment and prognosis of cerebral sparganosis.
Methods Clinical data of 83 patients with cerebral sparganosis in Guangdong 999 Brain Hospital from July 2004 to
January 2020 were collected, and the general conditions, clinical manifestations, laboratory examination, imaging
features, treatment and prognosis were analyzed. Results The 83 patients came from different areas of China,
including 46 from Guangdong Province, 12 from Hunan Province, 11 from Guangxi Province, 8 from Jiangxi Province
and 6 from others. There were 48 males and 35 females. The youngest case was 8 years old and the oldest was
71. The longest course was 360 months and the shortest was 2 days. A clear history of unclean diet was found in
68.7% (57/83) patients. The main clinical symptoms were epilepsy (84.3% , 70/83), headache (32.5% , 27/83), limb
hemiplegia (26.5% , 22/83), speech disorder (10.8% , 9/83), visual impairment (7.2%, 6/83), and paresthesia(6% , 5/83).
Blood examination showed an increase of leukocytes count in 7 of 83 cases, 9 cases with increased eosinophils
count, and 4 cases with increased lymphocytes. C鄄reactive protein detection was performed in 27 cases, and 2 cases
showed elevation. Serological detection of metacercaria antibody by ELISA was performed in 80 patients, and 77 cases
were positive. Cerebrospinal fluid detection of metacercaria antibody by ELISA was performed in 46 cases and 23 cases
were revealed positive. Seventy patients were examined by electroencephalogram, 30 cases showed slow wave
abnormality, and 17 cases had epileptiform discharge and clinical seizure. Calcification was observed on CT scan of
41 cases. Brain MRI enhancement showed tunnel sign鄄like changes in 75 cases and bead鄄like enhancement in 83
cases. Fifty鄄eight patients were treated with surgery, and from 42 of them, 43 white flat cotton thread live worms
were obtained. At follow鄄up of 3 months to 8 years, 52 cases were cured, 6 cases were still progressing or not
cured; 55 patients with epilepsy who underwent surgery were followed up, of whom 80%(44/55) reached the modified
Engel grade I. Twenty鄄five cases were treated with praziquantel, and at follow up for 3 months to 8 years, 7 cases
were cured, 18 cases were still progressing or not cured. Eleven patients with epilepsy were treated with praziquantel
and followed up, and only 27.3%(3/11) reached the modified Engel grade I. Conclusion Epileptic seizures are the
main clinical manifestations of cerebral sparganosis. Clinical diagnosis can be made according to serum immunological
examination and imaging features. Surgery is an efficient approach to removing live worms and curing patients.
揖Key words铱 Cerebral sparganosis; Live worm; Epilepsy; Magnetic resonance imaging曰 Microsurgery
A B C D
E F G H
表3 脑裂头蚴病继发癫痫手术患者和未手术患者的改良Engel分级
Table 3 Modified Engel Grade of cerebral sparganosis with secondary epilepsy after surgery and not operated on
parasitic encephalopathy 咱J暂. Chin J Parasitol Parasit Dis, 咱14暂 Hua G, Tan HP, Zhang LM, et al. Diagnosis and surgical
2002, 20(3): 177鄄179. (in Chinese) treatment of cerebral sparganosis 咱J暂. Chin J Clin Neurosurg,
( 尹 春 煜 , 石 尧忠 . 食物 源 性 脑 寄生 虫 病 住 院 病 例 分 析 咱J暂. 2018, 23(3): 191鄄193. (in Chinese)
中国寄生虫学与寄生虫病杂志, 2002, 20(3): 177鄄179.) (华刚, 谭红平, 张立民, 等. 脑裂头蚴病的诊断和手术治疗
咱8 暂 Jin X, Liu PF, Sun ZQ, et al. Strategy and experience of 体会咱J暂. 中国临床神经外科杂志, 2018, 23渊3冤: 191鄄193.)
surgical treatment for cerebral sparganosis 咱J暂. Chin J Neu鄄 咱15暂 Jin X, Tan JL, Sun ZQ, et al. Experience in diagnosis and
romedicine, 2019, 18(5): 522鄄527. (in Chinese) successful removal of live worms for cerebral echinococcosis
(金鑫, 刘朋飞, 孙祯卿, 等. 脑裂头蚴病手术治疗经验探讨 咱J暂. J Clin Neurosurg, 2019, 16 (6): 518鄄521, 526. (in Chi鄄
咱J暂. 中华神经医学杂志, 2019, 18(5): 522鄄527.) nese)
咱9暂 Moon WK, Chang KH, Cho SY, et al . Cerebral sparganosis: (金鑫, 谭家亮, 孙祯卿, 等. 脑裂头蚴病的诊断及手术取出
MR imaging versus CT features 咱J暂. Radiology, 1993, 188 (3): 活虫的经验咱J暂. 临床 神经外 科杂 志, 2019, 16 (6): 518鄄521,
751鄄757. 526.)
咱10暂 Wang WS, Song T, Wang Y, et al. The imaging characteris鄄 咱16暂 Lo Presti A, Aguirre DT , de Andr佴s P , et al . Cerebral
tics of cerebral sparganosis 咱J暂. J Clin Radiol, 2010, 29 (5): sparganosis: case report and review of the European cases咱J暂.
579鄄583. (in Chinese) Acta Neurochir, 2015, 157(8): 1339鄄1343.
(汪文胜, 宋亭, 王颖, 等. 脑裂头蚴病的影像学特征咱J暂. 临 咱17暂 Deng L, Xiong PJ, Qian SK. Diagnosis and stereotactic aspi鄄
床放射学杂志, 2010, 29(5): 579鄄583.) ration treatment of cerebral sparganosis: summary of 11 cases
咱11暂 Kim H, Kim SI , Cho SY . Serological diagnosis of human 咱J暂. J Neurosurg, 2011, 114(5): 1421鄄1425.
sparganosis by means of micro鄄ELISA咱J暂. Korean J Parasitol, 咱18暂 Expert group of Chinese Anti鄄epilepsy Association. expert con鄄
1984, 22(2): 222. sensus on the use of antiepileptic drugs after surgery for
咱12暂 Gonzenbach RR, Kong Y, Beck B, et al. High鄄dose prazi鄄 craniocerebral diseases 咱J暂. Chin J Neurosurg, 2012, 28 (7):
quantel therapy for cerebral sparganosis 咱J暂. J Neurol, 2013, 751鄄754. (in Chinese)
260(5): 1423鄄1425. (中国抗癫痫协会专家组. 颅脑疾病手术后抗癫痫药物应用
咱13暂 Lo Presti A , Aguirre DT , de Andr佴s P , et al . Cerebral 的 专 家 共 识 ( 试 行 ) 咱J暂. 中 华 神 经 外 科 杂 志 , 2012, 28 (7):
sparganosis: case report and review of the European cases咱J暂. 751鄄754.)
Acta Neurochir, 2015, 157(8): 1339鄄1343. 渊收稿日期院 2020鄄06鄄27 编辑院 衣凤芸冤