Àçåðбàéäaeàíñêèé ìåäèöèíñêèé óíèâåðñèòåò, ã. Бàêó, ÀçåðбàéäaeàíПðåäñòàâëåíы ðåзóëüòàòы хèðóðãèчåñêîãî ëåчåíèя 36 бîëüíых ñ мíîaeåñòâåííым эхèíîêîê-êîзîм ãîëîâíîãî мîзãà. Рåòðîñïåêòèâíыé àíàëèз êàчåñòâà äèàãíîñòèêè è ëåчåíèя мíîaeåñòâåííîãî эхèíîêîêêîзà ãîëîâíîãî мîзãà ó бîëüíых äî 1985 ã. ñëåäóåò ïðèзíàòü íåóäîâëåòâîðèòåëüíым. Âíåäðåíèå êîмïüюòåðíîé (ÊТ) è мàãíèòîðåзîíàíñíîé (МРТ) òîмîãðàфèè ïîзâîëèëî âыяâëяòü эхèíîêîêêîâыå êèñòы íåзàâèñèмî îò èх âåëèчèíы (äèàмåòðîм îò 5-6 äî 12-13 ñм), чèñëà è ëîêàëèзàöèè â ãîëîâíîм мîзãó, à òàêaeå ïðîâîäèòü äèффåðåíöèàëüíóю äèàãíîñòèêó ñ äðóãèмè îбъåмíымè îбðàзîâàíèямè. Мíîaeåñòâåííыé эхèíîêîêêîз ãîëîâíîãî мîзãà яâëяåòñя ñмåðòåëü-íым зàбîëåâàíèåм, âàaeíîå óñëîâèå бëàãîïðèяòíîãî èñхîäà -ñâîåâðåмåííîå ðàñïîзíàâàíèå ïàòîëîãèè äî âîзíèêíîâåíèя îчàãîâых íåâðîëîãèчåñêèх ñèмïòîмîâ è ïðèзíàêîâ äèñëîêàöèè ãîëîâíîãî мîзãà. Ëåчåíèå мíîaeåñòâåííîãî эхèíîêîêêîзà ãîëîâíîãî мîзãà òîëüêî хèðóðãèчåñêîå, îïòèмàëüíым мåòîäîм яâëяåòñя шèðîêàя êðàíèîòîмèя ñ óäàëåíèåм эхèíîêîêêîâîé êèñòы бåз ïîâðåaeäåíèя åå êàïñóëы.Кëючåâыå ñëîâà: ãîëîâíîй ìîçã, ìíîaeåñòâåííый эõèíîêîêêîç, õèðóðãèчåñêîå ëåчåíèå Â íåéðîхèðóðãèчåñêîé ïðàêòèêå àêòóàëüíы ðàзëèчíыå àñïåêòы ïðîфèëàêòèêè è хèðóðãèчåñ-êîãî ëåчåíèя эхèíîêîêêîзà ãîëîâíîãî мîзãà [10]. Бîëüшèíñòâî àâòîðîâ [4,6,7] íà îñíîâàíèè ñîбñòâåí-íых íàбëюäåíèé êîíñòàòèðîâàëè, чòî чàñòîòà эхè-íîêîêêîâîãî ïîðàaeåíèя ãîëîâíîãî мîзãà ñîñòàâëяåò îò 7 äî 9 %, îíî зàíèмàåò 7-å мåñòî â ñòðóêòóðå âñåх îбüåмíых âíóòðèчåðåïíых ïîðàaeåíèé ðàзëèчíîãî ãåíåзà. Цåëüю ñîîбщåíèя яâèëîñü èзóчåíèå îñîбåí-íîñòåé êëèíèчåñêîãî òåчåíèя, äèàãíîñòèêè è мåòîäîâ ëåчåíèя бîëüíых ñ мíîaeåñòâåííым эхèíîêîêêîзîм ãîëîâíîãî мîзãà. Сîâåðшåííî èíàя ñèòóàöèя îòмåчåíà ïîñëå âíåäðåíèя â ïðàêòèêó ÊТ è МРТ, чòî ïîзâîëèëî âыяâëяòü эхèíîêîêêîâыå êèñòы íåзàâèñèмî îò èх âåëèчèíы (äèàмåòðîм îò 5-6 мм äî 12-13 ñм), чèñ-ëà è ëîêàëèзàöèè â ðàзëèчíых îòäåëàх ãîëîâíîãî мîзãà, à òàêaeå ïðîâîäèòü äèффåðåíöèàëüíóю äèàãíîñòèêó ñ äðóãèмè îбüåмíымè îбðàзîâàíèямè ãîëîâíîãî мîзãà [1,2].Мíîaeåñòâåííыå îäíîêàмåðíыå ïàðàзèòàðíыå êèñòы ðàñïîëàãàëèñü â ðàз-íых äîëях îäíîãî ïîëó-шàðèя бîëüшîãî мîзãà (ó äåòåé â âîзðàñòå îò 4 äî 10 ëåò, ó âзðîñëых -îò 35 äî 52 ëåò) ëèбî îäíîâðåмåííî â îбîèх ïîëóшàðèях (ó äåòåé îò â âîзðàñòå 6 äî 17 ëåò, ó âзðîñëых -îò 40 äî 55 ëåò). Ó 8 бîëüíых (7 äåòåé è 1 âзðîñëîãî) мíîaeåñòâåííыå êèñòы ëîêàëèзîâàëèñü âíóòðè aeåëóäîчêîâ мîзãà, îòäåëüíыå êèñòы -ïà-ðàâåíòðèêóëяðíî â òîм aeå ïîëóшàðèè. Ó 6 бîëüíых äèàãíîñòèðîâàíы êèñòы ñóïðà-è ñóбòåíòîðèàëüíîé ëîêàëèзàöèè.Пðè îбñëåäîâàíèè ó 3 бîëüíых îбíàðóaeåíы эхè-íîêîêêîâыå êèñòы â ëåãêèх, ó 2 -â ïåчåíè.Пàòîãíîмîíèчíым, äåíñèòîмåòðèчåñêèм ïðèзíà-êîм эхèíîêîêêîâîé êèñòы (ïî äàííым ÊТ è МРТ) быëî îбüåмíîå îбðàзîâàíèå îêðóãëîé фîðмы, ãèïîäåíñèâ-íîå. Пðè эòîм êàêîé-ëèбî ðàзäåëèòåëüíîé êàïñóëы, à òàêaeå ïàðåíхèмàòîзíîãî èëè "ïàëüöåâèäíîãî" îòåêà âåщåñòâà мîзãà, êàê ïðàâèëî, íå íàбëюäàëè. Â êèñòàх äèàмåòðîм бîëåå 5 ñм îòмåчàëè ñèмïòîм ñåäèмåíòàöèè âñëåäñòâèå ñêîïëåíèя â ïîëîñòè êèñòы мíîãîчèñëåííых ñêîëåêñîâ.«Аãðåññèâíîñòü» êèñòы îбóñëîâëåíà îбüåмíым эффåêòîм ðàзëèчíîé ñòå...
According to the literature, the successful results of surgical treatment of patients operated on for compression of the spinal cord and cervical spine roots vary within a fairly wide range - from 55% to 96%. It seemed important to us in the early stages after surgical treatment to assess in the age aspect its effectiveness, the dynamics of clinical symptoms and general physical condition of patients, their satisfaction with the results of the operation. We analyzed the results of surgical treatment of 44 patients suffering from a herniated disc of the cervical spine. Patients underwent surgical treatment, including discectomy (7), laminectomy (2), corporectomy and anterior corporodesis (1), discectomy and autoplasty (7), discectomy and cage placement (27). The performed surgical treatment led to the achievement of stabilization of the spine and regression of the neurological status, including the absence of pain, an increase in the volume and strength of active movements in the limbs, restoration of the functions of the pelvic organs, and improvement of sensitivity.
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