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目的:总结立体定向活检术在诊断艾滋病(AIDS)伴发颅内病变诊断中的经验,探讨手术方法及技术要点、如何降低手术并发症以及提高阳性诊断率。方法:回顾性分析7例行脑立体定向活检术AIDS伴发颅内病变患者(男4例,女3例;年龄15-49岁),病史1月-1年。均行核磁共振定位立体定向脑活检术,活检标本术后行常规HE染色及免疫组化病理学检查。结果:7例患者手术顺利,病理结果示:脑弓形虫病2例,隐球菌脑炎2例,巨细胞脑炎2例,结核性脓肿1例,星形细胞瘤1例,其中1例为脑弓形虫病和隐球菌脑炎共同感染。诊断成功率100%,术后并发症率14.3%(1/7),无死亡。术后随访6月-6年,1例完全康复,4例症状明显好转,2例死亡。结论:立体定向活检术是诊断AIDS伴发颅内病变安全、有效的方法,有助于协助诊断、制定治疗方案和改善预后。
OBJECTIVE: To summarize the experience of stereotactic biopsy in the diagnosis of AIDS associated with intracranial lesions, to explore the surgical methods and techniques, how to reduce the complications and to improve the positive diagnosis rate. Methods: Retrospective analysis of 7 cases of brain stereotactic biopsy patients with AIDS associated with intracranial lesions (4 males and 3 females; aged 15-49 years), history of January to January. All patients underwent stereotactic brain biopsy with magnetic resonance imaging. The biopsy specimens were examined by routine HE staining and immunohistochemistry. Results: The operation was successful in 7 patients. The pathological results showed 2 cases of Toxoplasmosis, 2 cases of cryptococcal encephalitis, 2 cases of giant cell encephalitis, 1 case of tuberculosis abscess and 1 case of astrocytoma, of which 1 case was Toxoplasmosis and cryptococcal encephalitis co-infection. The success rate of diagnosis was 100%. The postoperative complication rate was 14.3% (1/7) and no death was found. All the patients were followed up for 6 months to 6 years. One patient recovered completely, the symptoms of four patients improved obviously and two patients died. Conclusion: Stereotactic biopsy is a safe and effective method for the diagnosis of intracranial lesions associated with AIDS, helping to diagnose, formulate treatment plans and improve prognosis.