9例西藏地区颅内寄生虫病临床病理观察  

Intracranial parasitosis in Tibet: a clinicopathological analysis of nine cases

作　　者：魏倩[1] 罗含欢[1] 廖瑞倩 霍真[2] WEI Qian;LUO Han-huan;LIAO Rui-qian;HUO Zhen(Department of Pathology,Tibet Autonomous Region People's Hospital,Lhasa 850000,China;Department of Pathology,PUMC Hospital,CAMS and PUMC,Bejing 100730,China)

机构地区：[1]西藏自治区人民医院病理科,拉萨850000 [2]中国医学科学院,北京协和医学院,北京协和医院病理科,北京100730

出　　处：《诊断病理学杂志》2022年第10期907-909,913,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的 总结西藏地区患者经手术切除病理确诊为颅内寄生虫病的临床特征、影像学特点、病理类型及治疗情况。方法 回顾性分析西藏自治区人民医院病理科2014-06—2021-06期间存档的经手术切除的9例颅内寄生虫病病例,收集临床资料,病理切片经光镜下重新阅片,记录病理形态学表现。结果 9例患者,男女比例5∶4,年龄9~74岁,均来自农牧区。主要临床表现为间断性头痛、恶心、呕吐等颅内压增高症状。影像学检查5例为颅内单发性占位,4例为多发性占位;病灶最大径2.5~12 cm。4例脑棘球蚴病病例术前诊断可疑寄生虫病,5例脑囊虫病病例术前诊断不明确。9例均手术治疗,其中5例病理诊断为脑囊虫病(3例为脑室型,2例为脑实质型),4例为脑棘球蚴病(3例为脑细粒棘球蚴病,1例为脑泡状棘球蚴病)。8例患者术后好转出院,3例患者有随访资料(平均随访60个月),均无复发,5例患者失访;1例泡状棘球蚴病患者术后病情缓解不明显,随访22个月后死亡。结论 西藏地区采取手术治疗的颅内寄生虫病较少见,其主要病理类型为囊虫病和棘球蚴病。Objective To summarize the clinical and imaging features, pathological types and treatment of intracranial parasitosis by surgical resection in Tibetan in Tibet region. Methods The clinical and pathological data of 9 cases of intracranial parasitosis diagnosed by pathology from Tibet Autonomous Region People’s Hospital from June 2014 to June 2021 were retrospectively analyzed. Results Nine patients, male to female ratio 5∶4, aged 9-74 years, and all patients were from agricultural and pastoral areas. The main clinical manifestations were intermittent headache, nausea and vomiting and other symptoms of increased intracranial pressure. Imaging examination showed single intracranial lesion in 5 cases and multiple lesions in 4 cases, and the maximum diameter of the lesion was 2.5-12 cm. Before operation, 4 cases were diagnosed as suspected parasitosis, and 5 cases were not clearly diagnosed. All 9 cases received surgical treatment, of which 5 cases were pathologically diagnosed as cerebral cysticercosis(3 cases were ventricular type and 2 cases were brain parenchymal type), 4 cases were cerebral echinococcosis(3 cases were cerebral cystic echinococcosis and 1 case was cerebral alveolar echinococcosis). 8 patients improved after operation, 3 patients had follow-up data(mean follow-up 60 months), none of them had recurrence, and 5 patients lost follow-up;One patient with cerebral alveolar echinococcosis had no obvious postoperative remission and died after 22 months. Conclusion Intracranial parasitosis by surgical treatment is rare in Tibet, and the main pathological types are cysticercosis and echinococcosis.

关 键 词：西藏地区 颅内寄生虫病 临床病理 手术治疗 

分 类 号：R381[医药卫生—医学寄生虫学]