唤醒麻醉联合术中导航抓取脑功能区裂头蚴病的疗效观察(附10例报告)

doi:10.19854/j.cnki.1008-2425.2021.05.0003

立体定向和功能性神经外科杂志 ›› 2021, Vol. 34 ›› Issue (5): 269-273.DOI: 10.19854/j.cnki.1008-2425.2021.05.0003

唤醒麻醉联合术中导航抓取脑功能区裂头蚴病的疗效观察(附10例报告)

邓心情, 付正浩, 毕中胜, 卢建侃, 孙晰博, 鲁明, 欧阳辉, 张亚梅

510510 广州广东三九脑科医院神经外五科

收稿日期:2021-09-15 发布日期:2022-02-15
通讯作者: 鲁明 doctorlm98@163.com

Observation of curative effect of removal echinococcosis in brain functional region by awakening anesthesia combined with intraoperative navigation

Deng Xinqing, Fu Zhenghao, Bi Zhongsheng, et al.

Department of Neurosurgery,Guangdong 999 Brain Hospital,Guangzhou 510510,China

Received:2021-09-15 Published:2022-02-15

摘要/Abstract

摘要： 目的探讨唤醒麻醉联合术中导航抓取脑功能区裂头蚴病的临床疗效。方法回顾性分析广东三九脑科医院神经外科2014年1月至2020年3月收治并成功抓取的10例脑功能区裂头蚴病患者的临床资料,分析其临床表现、血清及脑脊液抗体检验、影像学检查及术后随访的结果。结果本组患者包含男性8例,女性2例,平均年龄39.20±13.46岁(22~63岁);有不洁饮水史或生吃食物史8例(8/10)。患者术前均有癫痫发作(100%),血清抗裂头蚴抗体阳性8例(8/10),均在同一部位抓取1条活虫。术后无再发癫痫发作7例(7/10)。术后头部MRI均提示原强化灶消失,无新发病灶,无死亡病例。结论应用唤醒麻醉联合术中导航技术抓取脑功能区裂头蚴病的成功率高,且不增加神经功能损害,值得临床推广应用。

关键词: 唤醒麻醉, 术中导航, 脑功能区, 裂头蚴病

Abstract: Objective To explore the clinical effect of awakening anesthesia combined with intraoperative navigation to capture of cerebral functional areas of echinococcosis. Methods A retrospective analysis was performed on the clinical data of 10 patients with cerebral sparganosis who were treated in the functional areas at the Department of Neurosurgery,Guangdong 999 Brain Hospital from January 2014 to March 2020,The clinical manifestations,serum and cerebrospinal fluid antibody tests,imaging examinations and postoperative follow-up results were analyzed. Results There were 8 males and 2 females in this group,with an average age of 39.20±13.46 years(22-63 years).8 cases(8/10) had a history of drinking unclean water or eating raw food.All patients had epileptic seizure before operation(100%),and 8 patients(8/10) had positive serum anti-cercariae antibody,and all of them captured a live worm from the same site.No recurrent seizures occurred in 7 cases(7/10).Postoperative MRI showed that the original enhanced lesions disappeared,no new lesions and no death cases. Conclusion The application of wake anesthesia combined with intraoperative navigation technology can capture the functional areas of the brain with a high success rate and does not increase the neurological damage,which is worthy of clinical application.

Key words: Wake-up anesthesia, Intraoperative navigation, Brain functional region, Cerebral sparganosis

中图分类号:

邓心情, 付正浩, 毕中胜, 卢建侃, 孙晰博, 鲁明, 欧阳辉, 张亚梅. 唤醒麻醉联合术中导航抓取脑功能区裂头蚴病的疗效观察(附10例报告)[J]. 立体定向和功能性神经外科杂志, 2021, 34(5): 269-273.

Deng Xinqing, Fu Zhenghao, Bi Zhongsheng, et al.. Observation of curative effect of removal echinococcosis in brain functional region by awakening anesthesia combined with intraoperative navigation[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2021, 34(5): 269-273.

参考文献

[1] Li MW,Song HQ,Li C,et al.Sparganosis in mainland China[J].Int J Infect Dis,2011,15(3):e154～e156.
[2] Hong D,Xie H,Zhu M,et al.Cerebral sparganosis in mainland Chinese patients[J].J Clin Neurosci,2013,20(11):1514～1519.
[3] Deng L,Xiong P,Qian S.Diagnosis and stereotactic aspiration treatment of cerebral sparganosis:summary of 11 cases[J].J Neurosurg,2011,114(5):1421～1425.
[4] Kim JG,Ahn CS,Sohn W M,et al.Human sparganosis in Korea[J].J Korean Med Sci,2018,33(44):e273.
[5] 闫学强,李晓龙,孙祯卿,等.83例脑裂头蚴病患者临床资料分析[J].中国寄生虫学与寄生虫病杂志,2021,39(2):240～245.
[6] Zhu Y,Ye L,Ding X,et al.Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings:a case report and literature review[J].BMC Infect Dis,2019,19(1):748.
[7] Zhang P,Zou Y,Yu FX,et al.Follow-up study of high-dose praziquantel therapy for cerebral sparganosis[J].PLoS Negl Trop Dis,2019,13(1):e7018.
[8] 谢慧群.脑曼氏裂头蚴病药物与手术干预后抗体水平变化的研究[D].南昌大学,2020.
[9] Liao H,Li D,Zhou B,et al.Imaging characteristics of cerebral sparganosis with live worms[J].J Neuroradiol,2016,43(6):378～383.
[10]Hong D,Xie H,Wan H,et al.Efficacy comparison between long-term high-dose praziquantel and surgical therapy for cerebral sparganosis:A multicenter retrospective cohort study[J].PLoS Negl Trop Dis,2018,12(10):e6918.
[11]金鑫,刘朋飞,孙祯卿,等.脑裂头蚴病手术治疗经验探讨[J].中华神经医学杂志,2019(5):522～527.
[12]谭家亮,吴杰,付东翔,等.脑裂头蚴病的特性与外科治疗策略[J].中国微侵袭神经外科杂志,2018,23(11):502～505.
[13]Kim DG,Paek SH,Chang K H,et al.Cerebral sparganosis:clinical manifestations,treatment,and outcome[J].Journal of neurosurgery,1996,85(6):1066.
[14]Caballero J,Morales L,Garcia D,et al.[Stereotactic aspiration of Spirometra mansonides larvae][J].Rev Chilena Infectol,2015,32(4):453～456.
[15]Nkwerem S,Goto T,Ogiwara T,et al.Ultrasound-Assisted Neuronavigation-Guided Removal of a Live Worm in Cerebral Sparganosis[J].World Neurosurg,2017,102:613～696.
[16]Yi W,Xu S,Li X,et al.Technique of Localizing the Central Sulcus under Awake Anesthesia for Treatment of Gliomas in or near Motor Areas[J].Turk Neurosurg,2019,29(3):323～327.
[17]金鑫,谭家亮,孙祯卿,等.脑裂头蚴病的诊断及手术取出活虫的经验[J].临床神经外科杂志,2019,16(6):518～521.

唤醒麻醉联合术中导航抓取脑功能区裂头蚴病的疗效观察(附10例报告)

Observation of curative effect of removal echinococcosis in brain functional region by awakening anesthesia combined with intraoperative navigation

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价