摘要
目的总结西藏自治区脑结核瘤的诊治经验。方法回顾性分析西藏自治区人民医院2013年9月至2021年9月手术治疗的16例脑结核瘤的临床资料。结果15例为脑内单发病灶行开颅显微镜下手术切除病灶;1例多发病灶,手术切除小脑蚓部较大病灶以及左侧丘脑较小病灶。术后均给予标准抗结核治疗2个月,停用吡嗪酰胺,其它3联化疗3个月~1年。16例术后病理检查均诊断为脑结核瘤。1例小脑半球较大病灶术后并发严重肺部感染、电解质紊乱,最终死亡;其余15例术后随访1年,改良Rankin量表评分0分,未见复发。结论西藏地区结核病高发,对颅内占位性病变,需重视与脑结核瘤鉴别。部分具有手术指征的脑结核瘤,积极手术治疗,联合术后规范抗结核治疗,疗效满意。
Objective To summarize the experience in diagnosis and treatment of cerebral tuberculomas in the Tibet Autonomous Region.Methods The clinical data of 16 patients with cerebral tuberculomas treated by operation in The People's Hospital of Tibet Autonomous Region from September 2013 to September 2021 were retrospectively analyzed.Results Fifteen patients with single lesions underwent craniotomy under a microscope,and 1 patient had multiple lesions whose larger lesion in the vermis of the cerebellum and the smaller lesion in the left thalamus were removed.Pyrazinamide was stopped in all patients who were given standard anti-tuberculosis therapy for 2 months,and the other 3 combined chemotherapy lasted for 3 months to 1 year.All patients were diagnosed with cerebral tuberculoma by postoperative pathological examination.The follow-up(1 year)showed a modified Rankin scale score of 0 in 15 patients without recurrence,and death in 1 patient with large cerebellar hemisphere lesions due to complicated with severe pulmonary infection and electrolyte disturbance after surgery.Conclusions There is a high incidence of tuberculosis in the Tibet Autonomous Region.Attention should be paid to the differentiation of intracranial space-occupying lesions from the cerebral tuberculoma.For the cerebral tuberculomas with surgical indications,surgical treatment combined with postoperative standard anti-tuberculous treatment can obtain good outcomes.
作者
多吉玉杰
扎多
刘焕东
曹旭东
王洪国
罗含欢
仁增
DUOJI Ru-jie;ZHA Duo;LIU Huan-dong;CAO Xu-dong;WANG Hong-guo;LUO Han-huan;REN Zeng(Department of Neurosurgery,The People's Hospital of Tibet Autonomous Region,Lhasa 850000,China;Department of Pathology,The People's Hospital of Tibet Autonomous Region,Lhasa 850000,China)
出处
《中国临床神经外科杂志》
2023年第2期83-85,共3页
Chinese Journal of Clinical Neurosurgery
关键词
脑结核瘤
西藏地区
诊断
手术治疗
Cerebral tuberculoma
Tibet Autonomous Region
Diagnosis
Surgical treatment
