本文選題：神經(jīng)梅毒　切入點(diǎn)：樹膠腫　出處：《蘇州大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:探討梅毒性神經(jīng)系統(tǒng)樹膠腫的非手術(shù)治療的臨床療效,進(jìn)一步提高臨床對該病的診療水平。 方法:回顧性分析6例梅毒性神經(jīng)系統(tǒng)樹膠腫患者的臨床資料、實(shí)驗(yàn)室檢查和影像學(xué)檢查結(jié)果及診療過程,臨床轉(zhuǎn)歸及隨訪資料。 結(jié)果:①梅毒性神經(jīng)系統(tǒng)樹膠腫患者臨床表現(xiàn)主要為頭痛;②患者血清和腦脊液梅毒學(xué)檢查為陽性,腦脊液細(xì)胞數(shù)和蛋白含量偏高;③患者CT和MRI表現(xiàn)為占位病變,MRI T1WI表現(xiàn)為低信號,T2WI表現(xiàn)為高信號,增強(qiáng)后病灶中央呈結(jié)節(jié)狀強(qiáng)化,病灶周圍有水腫;④梅毒性神經(jīng)系統(tǒng)樹膠腫的病理表現(xiàn)為血管內(nèi)皮、血管明顯增生,大量以漿細(xì)胞為主的炎性細(xì)胞浸潤,不一定有壞死;⑤梅毒性顱內(nèi)樹膠腫容易誤診為顱內(nèi)腫瘤,通常手術(shù)治療;⑥手術(shù)組3例患者術(shù)后行藥物驅(qū)梅治療后臨床完全恢復(fù),非手術(shù)組的2例顱內(nèi)樹膠腫患者行藥物驅(qū)梅治療后臨床也完全恢復(fù),脊髓樹膠腫非手術(shù)治療后臨床得到明顯改善。 結(jié)論:梅毒性神經(jīng)系統(tǒng)樹膠腫的診斷需結(jié)合梅毒感染史、臨床表現(xiàn)、實(shí)驗(yàn)室及影像學(xué)檢查綜合分析;影像學(xué)主要表現(xiàn)為占位病變,周邊水腫,增強(qiáng)掃描可見強(qiáng)化;非緊急情況下非手術(shù)治療是梅毒性神經(jīng)系統(tǒng)樹膠腫的首選方法,臨床療效顯著,并可以避免各種手術(shù)的并發(fā)癥;驅(qū)梅治療首選水劑青霉素,也可聯(lián)合糖皮質(zhì)激素治療;梅毒性脊髓樹膠腫非手術(shù)治療的臨床療效較顱內(nèi)樹膠腫稍差。
[Abstract]:Objective: to investigate the clinical effect of non-operative treatment of syringomelopathy of nervous system and to improve the clinical diagnosis and treatment of the disease. Methods: the clinical data, laboratory and imaging findings, diagnosis and treatment process, clinical outcome and follow-up data of 6 cases of syphilis nerve system gum swelling were retrospectively analyzed. Results the clinical manifestations of the patients with syphilis of the syphilis of the syphilis in the serum and cerebrospinal fluid of the patients with syphilis were positive. The CT and MRI findings of cerebrospinal fluid (CSF) with high cell count and protein content were as follows: Mr T1WI showed low signal intensity on T _ 2WI and nodular enhancement in the center of the lesion after contrast enhancement. The pathological features of the edema around the lesions were vascular endothelium, obvious proliferation of blood vessels, a large number of inflammatory cells infiltrated mainly by plasma cells, and not necessarily necrotic and syphilis toxic intracranial gum swelling, which were easily misdiagnosed as intracranial tumors. The clinical data of 3 patients in the operation group and 2 patients in the non-operative group were completely recovered after the drug treatment, and the patients in the non-operative group were treated with the drug repellent therapy, and the patients in the non-operative group were treated with drug repellent therapy. After non-operative treatment of spinal cord gum, the clinical results were significantly improved. Conclusion: the diagnosis of syphilis infection, clinical manifestation, laboratory and imaging examination should be combined with the diagnosis of syphilis infection. Non-operative treatment is the first choice method for syringomelopathy of nervous system, and the clinical effect is remarkable, and can avoid the complications of all kinds of surgery, the water agent penicillin is the first choice in the treatment of plum repellent, it can also be combined with glucocorticoid treatment. The clinical effect of non-operative treatment of syphilis spinal cord gum was slightly worse than that of intracranial gum.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R759.1

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本文編號：1645339