[1]多吉玉杰,扎多,刘焕东,等.西藏自治区脑结核瘤手术治疗分析（附16例报道并文献复习）[J].中国临床神经外科杂志,2023,28(02):83-85.[doi:10.13798/j.issn.1009-153X.2023.02.006]
　DUOJI Ru-jie,ZHA Duo,LIU Huan-dong,et al.Surgical treatment of cerebral tuberculomas in the Tibet Autonomous Region (report of 16 cases and literature review)[J].,2023,28(02):83-85.[doi:10.13798/j.issn.1009-153X.2023.02.006]
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西藏自治区脑结核瘤手术治疗分析（附16例报道并文献复习）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年02期
页码:
83-85
栏目:
论著
出版日期:
2023-02-28

文章信息/Info

Title:
Surgical treatment of cerebral tuberculomas in the Tibet Autonomous Region (report of 16 cases and literature review)
文章编号:
1009-153X（2023）02-0083-03
作者:
多吉玉杰; 扎多; 刘焕东; 曹旭东; 王洪国; 罗含欢; 仁增
850000拉萨，西藏自治区人民医院神经外科（多吉玉杰、扎多、刘焕东、曹旭东、王洪国、仁增），病理科（罗含欢）
Author(s):
DUOJI Ru-jie1;  ZHA Duo1;  LIU Huan-dong1;  CAO Xu-dong1;  WANG Hong-guo1;  LUO Han-huan2;  REN Zeng1
1. Department of Neurosurgery, The People's Hospital of Tibet Autonomous Region, Lhasa 850000, China; 2. Department of Pathology, The People's Hospital of Tibet Autonomous Region, Lhasa 850000, China
关键词:
脑结核瘤; 西藏地区; 诊断; 手术治疗
Keywords:
Cerebral tuberculoma;  Tibet Autonomous Region;  Diagnosis;  Surgical treatment
分类号:
R739.41;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2023.02.006
文献标志码:
A
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。
Abstract:
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.

参考文献/References:

[1]张宝莹，其美卓嘎. 2017年西藏自治区结核病报告发病情况分析[J]. 全科口腔医学杂志（电子版），2019，6（12）：139.
[2]陶胜忠，尹先印，张鹏远，等. 脑结核瘤的诊断及治疗（附17例报告）[J]. 中国神经精神疾病杂志，2012，38（8）：496-498.
[3]项永生，刘灵慧，陈善成，等. 脑结核瘤的诊断和手术治疗[J]. 中华神经医学杂志，2005，4（l0）：1051-1052.
[4]Suslu HT, Bozbuga M, Bayindir C. Cerebral tuberculoma mimicking high grade glial tumor [J]. Turkish Neurosurg, 2010, 21(3): 427-429.
[5]邓长阳，李学军，黄纯海，等. 颅内结核瘤病人的临床特征分析（附18例报道）[J]. 医学临床研究，2009，26（5）：892-893.
[6]Katti MK. Pathogenesisi, diagnosis, treatment, and outcome aspects of cerebral tuberculosis [J]. Med Sci Monit, 2004, 10(9): 215-229.
[7]周良辅. 现代神经外科学[M]. 上海：复旦大学出版社，2015. 524-525.
[8]Torres C, Riascos R, Figueroa R, et al. Central nervous system tuberculosis [J]. Top Mag Reson Imaging, 2014, 23(3): 173-189.
[9]马　盼，施申启，宋　健，等. 脑结核瘤的诊治进展[J]. 中国临床神经外科杂志，2019，24（3）：181-184.
[10]关泓志，周祥琴，陈　琳，等. 脑多发性结核瘤11例的临床、脑脊液细胞学与病理特点[J]. 中华神经外科杂志，2006，39（12）：810-813.
[11]Thwaites G, Fisher M, Hemingway C, et al. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children [J]. J Infec, 2009, 59(3): 167-187.
[12]郑　勇，成振林，董　军，等. 脑结核瘤的诊断与外科治疗[J]. 中外医学研究，2014，12（6）：15-17.

备注/Memo

备注/Memo:
（2022-12-24收稿，2023-01-20修回）
通讯作者：仁　增，E-mail：renzeng-75@163.com
更新日期/Last Update: 2022-03-31