儿童脑型肺吸虫病合并颅内动静脉畸形临床分析  

Clinical analysis on cerebral paragonimiasis accompanied with intracranial arteriovenous malformations in children

作　　者：吴宣萱[1] 梁平[1] 李映良[1] 李禄生[1] 周渝冬[1] 翟瑄[1] 

机构地区：[1]重庆医科大学附属儿童医院神经外科,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆市儿童发育重大疾病诊治与预防国际科技合作基地,重庆400014

出　　处：《第三军医大学学报》2015年第22期2293-2296,共4页Journal of Third Military Medical University

基　　金：国家临床重点专科建设项目{国卫办医函[2013]544};重庆市卫生局医学科研计划项目(2009-2-264)~~

摘　　要：目的探讨儿童脑型肺吸虫病合并颅内动静脉畸形的临床表现、诊断及治疗方法。方法回顾2011-2013年我科收治的6例脑型肺吸虫病合并颅内动静脉畸形患儿资料,对其病因、临床表现、辅助检查、诊断、治疗及愈后进行分析总结。结果 6例脑型肺吸虫病合并颅内动静脉畸形患儿,其中男性4例,女性2例,年龄5-8岁,平均6.4岁,均来自疫区,以颅内出血和感染为主要表现,肺吸虫抗体（＋）,增强CT或计算机断层扫描血管成像（CTA）提示脑内异常血管团,给予驱虫和手术切除治疗。切除病变组织病理检查提示异常血管,驱虫治疗后复查肺吸虫抗体（-）,随访1-4年,颅内未再出血。结论详细病史和增强CT扫描能确诊儿童脑型肺吸虫病合并颅内动静脉畸形,早治疗能有效降低颅内再出血风险和保护神经功能。Objective To analyze the clinical manifestations,diagnosis and treatment of cerebral paragonimiasis accompanied with intracranial arteriovenous malformations in children. Methods A total of 6children with cerebral paragonimiasis accompanied with intracranial arteriovenous malformations admitted in our hospital from 2011 to 2013 were recruited in this study. Their etiology,clinical manifestations,auxiliary examinations,diagnosis,treatment and prognosis were analyzed and summarized. Results The 6 patients were 4 males and 2 females,at a median age of 6. 4（ ranging from 5 to 8）,and all of them came from epidemic stricken areas. The patients presented with acute intracerebral hemorrhage and infection,and their sera were positive to paragonimus antibodies. Enhanced computed tomography（ CT） or computed tomography angiography（ CTA） scanning suggested cerebral arteriolar abnormalities. After surgical treatment and expelling parasite,all patients were recovered. No intracerebral hemorrhage occurred in 1 to 4 years ＇ follow-up.Conclusion Detailed medical history and CT scanning can diagnose children with cerebral paragonimiasis accompanied with intracranial arteriovenous malformations. Early treatment can effectively reduce the risk of intracerebral hemorrhage and protect nerve function.

关 键 词：脑型肺吸虫病 颅内动静脉畸形 儿童 

分 类 号：R725.322[医药卫生—儿科]