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目的 :提高对脑结核瘤的诊治和预后的判断水平。方法 :对 6 2例脑结核瘤患者行颅脑CT及增强检查并同时进行MRI检查。随机将患者分为两组 :治疗组 32例 ,采用正规短程强化抗痨治疗加青霉素或先锋霉素静脉注射 ;而对照组 30例仅做正规强化治疗 ,并随访 2年。结果 :2年后治愈率两组均为 10 0 %。临床症状、体征均在治疗后 1～ 2个月消失。治疗后 4～ 6个月CT示病灶消失 5 5例、11～ 12个月时病灶消失 4例 ,另 3例遗有小钙化灶。癫痫起病者治疗 2年后停服抗癫痫药 ,未见癫痫再发作。两组疗效无差异。结论 :CT对脑结核瘤的诊断和病情观察有重要价值 ,MRI无优越性 ,治疗上无需加用其它抗生素
Objective: To improve the diagnosis and treatment of brain tuberculosis and prognosis of the level of judgment. Methods: Sixty-two patients with brain tuberculoma underwent brain CT and MRI examinations. The patients were randomly divided into two groups: the treatment group of 32 cases, using regular short-course intensive anti-tuberculosis therapy plus penicillin or cephalosporin intravenously; while the control group, 30 cases were only regular intensive treatment, and followed up for 2 years. Results: The cure rate after two years was 100% in both groups. Clinical symptoms and signs disappeared 1 to 2 months after treatment. After treatment 4 to 6 months CT showed focal lesions disappeared 5 5 cases, 11 to 12 months when the lesions disappeared in 4 cases, the other 3 left behind a small calcification. Epilepsy onset treatment stopped taking antiepileptic drugs after 2 years, no recurrent seizures. No difference between the two groups. Conclusion: CT is of great value in the diagnosis and observation of brain tuberculoma. MRI has no superiority and need not add other antibiotics