AIDS伴颅内占位性病变的立体定向活检术分析  

Application of stereotactic biopsy in patients with AIDS associated with intracranial space-occupying lesions:report of 19 cases

作　　者：陈思 唐忠[1] 王辉[2] 季玮 周泱[2] 初明 彭巧丽[2] 廖广生 黄东东 余凤仪 CHEN Si;TANG Zhong;WANG Hui;JI Wei;ZHOU Yang;CHU Ming;PENG Qiao-li;LIAO Guang-sheng;HUANG Dong dong;YU Feng-yi(Department of Neurosurgery,Third Affiliated Municipal People's Hospital/Second Affiliated College of Southern University of Science and Technology,Shenzhen 518112,China;Department of Infection,Third Affiliated Municipal People's Hospital/Second Affiliated College of Southern University of Science and Technology,Shenzhen 518112,China)

机构地区：[1]深圳市第三人民医院/南方科技大学第二附属医院神经外科,广东518112 [2]深圳市第三人民医院/南方科技大学第二附属医院感染一科,广东518112

出　　处：《中国临床神经外科杂志》2023年第4期240-242,共3页Chinese Journal of Clinical Neurosurgery

基　　金：“十三五”国家科技重大项目(2018ZX10302104-001);广东省深圳市科技计划项目(JCYJ20210324132012035)。

摘　　要：目的探讨立体定向活检术在获得性免疫缺陷综合征(AIDS)伴颅内占位性病变病人中的应用价值。方法回顾性分析2017年8月至2021年12月收治的19例AIDS病人伴颅内占位性病变的临床资料,均行立体定向活检术取闹组织进行病理检查。结果19例中,18例获得确诊,诊断阳性率为94.74%;其中真菌感染7例,肿瘤3例,进行性多病灶脑白质病、HIV脑病2例、结核肉芽肿各2例,弓形虫病、病毒性脑炎各1例。1例(5.26%)术后病理检查诊断不明确。术后出现穿刺道少量出血1例(5.26%),无神经功能障碍,无手术死亡病例。根据活检术后病理结果给予相应治疗,随访4个月~1年,平均6个月,复查颅脑增强MRI显示15例病灶变小、数量减少和(或)周围水肿减少,好转率为78.95%;4例无明显变化。结论AIDS病人伴发的颅内占位性病理性质多样,立体定向活检术能提供精准的诊断,并具有微创、安全的优点,可为治疗方案的制定提供有效的依据,提高临床治疗效果。Objective To investigate the application value of stereotactic biopsy in patients with acquired immune deficiency syndrome(AIDS)associated with intracranial space-occupying lesions.Methods The clinical data of 19 patients with AIDS complicated with intracranial space-occupying lesions who underwent stereotactic biopsy from August 2017 to December 2021 were retrospectively analyzed.Results Of 19 patients,18 patients(94.74%)were definitely diagnosed by postoperative pathological examination,including 7 patients of fungal infection,3 tumors,2 progressive multifocal leukoencephalopathy,2 HIV encephalopathy,2 tuberculous granuloma,1 toxoplasmosis and 1 viral encephalitis.One patient did not definitely diagnosed by postoperative pathological examination.A small amount of bleeding in the puncture path occurred in 1 patient(5.26%)after surgery.There were no neurological dysfunction or surgical death.The corresponding treatment was given according to the pathological results after biopsy,and the follow-up ranged from 4 months to 1 year,with an average of 6 months.Contrast enhanced MRI showed that the intracranial lesions were reduced in 15 patients(78.95%),and did not significantly change in 4 patients.Conclusions The pathological results are diverse in AIDS patients with intracranial space-occupying lesions.Stereotactic biopsy can provide accurate diagnosis with the advantages of minimally invasive and safe,which can provide effective basis for the treatment plan and improve treatment effect.

关 键 词：获得性免疫缺陷综合征 艾滋病 颅内占位性病变 立体定向活检术 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]