78例脑寄生虫病病例分析

中国寄生虫学与寄生虫病杂志 ›› 2009, Vol. 27 ›› Issue (3): 13-248.

78例脑寄生虫病病例分析

王淑梅^{1, 2}, 杨飞飞¹, 黄玉仙¹ *, 施光峰¹, 翁心华¹

1 复旦大学附属华山医院感染科, 上海 200040； 2 南昌市传染病医院, 南昌 330002

收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-06-30 发布日期:2009-06-30
通讯作者: 黄玉仙

Clinical Analysis of 78 Cases of Parasitic Encephalopathy

WANG Shu-mei^{1, 2}, YANG Fei-fei¹, HUANG Yu-xian¹ *, SHI Guang-fen¹, WENG Xin-hua¹

1 Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai 200040, China； 2 Nanchang Infectious Disease Hospital, Nanchang 330002, China

Received:1900-01-01 Revised:1900-01-01 Online:2009-06-30 Published:2009-06-30
Contact: HUANG Yu-xian

摘要/Abstract

摘要： 目的　探讨近几年来脑寄生虫病的流行病学、临床特点、治疗和转归情况。方法回顾性分析本院2003年6月～2008年6月收治的脑寄生虫病78例。结果　脑寄生虫病78例中, 男性52例, 女性26例, 平均年龄为（34.5±11.4）岁, 有食生肉史者占32.1%（25/78）；脑囊尾蚴病占78.2%（61/78）, 脑裂头蚴病占15.4%（12/78）, 脑并殖吸虫病占3.8%（3/78）, 脑弓形虫病占2.6%（2/78）。临床表现依次为癫痫、头痛、恶心、呕吐、视力及听力下降、面瘫、智能障碍等。其中内科保守治疗有效54例（69.2%）, 内、外科联合治疗9例, 有效的7例。78例中42例首次就诊诊断为脑寄生虫病, 误诊率达46.1% （36/78）。结论　脑寄生虫病的发病率与食生肉史有一定相关性, 临床上易误诊, 内、外科联合治疗效果较好。

关键词: 食物源性, 脑寄生虫病, 脑囊尾蚴病, 脑裂头蚴病, 脑并殖吸虫病, 脑弓形虫病

Abstract: Objective To investigate the epidemiology, clinical characteristics, therapeutic approaches and outcomes of parasitic encephalopathy. Methods A retrospective study was carried out to analyze 78 cases of parasitic encephalopathy in Huashan Hospital between June 2003 and June 2008. Results There were 52 male and 26 female patients with a mean age of （34.5±11.4）years. Among these patients, 32.1%（25/78）had a history of eating raw, neurocysticercosis accounted for 78.2%（61/78）, cerebral sparganosis 15.4%（12/78）, cerebral paragonimiasis 3.8%（3/78）, and cerebral toxoplasmosis 2.6%（2/78）. The common clinical features were epilepsy, headache, nausea, vomiting, vision and hearing loss, facial paralysis and mental retardation. Internal medical therapy resulted in an improvement in 69.2% of the patients. 7 out of 9 patients got improved or cured by combined surgical and internal medical treatment. 42 cases were diagnosed as parasitic encephalopathy while 36 cases（46.1%）were once misdiagnosed as other disorders. Conclusion Parasitic encephalopathy is associated with a history of eating raw, with a high rate of misdiagnosis. Internal medicine combined with surgery is an effective way for the therapy.

Key words: Food-borne, Parasitic encephalopathy, Neurocysticercosis, Cerebral sparganosis, Cerebral paragonimiasis, Cerebral toxoplasmosis

王淑梅;;杨飞飞;黄玉仙;施光峰;翁心华. 78例脑寄生虫病病例分析[J]. 中国寄生虫学与寄生虫病杂志, 2009, 27(3): 13-248.

WANGShu-mei;;YANGFei-fei;HUANGYu-xian*;SHIGuang-fen;WENGXin-hua. Clinical Analysis of 78 Cases of Parasitic Encephalopathy[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2009, 27(3): 13-248.

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