单纯脾包虫病的临床特征与诊治分析

Clinical characteristics, diagnosis and treatment of single lienal hydatidosis

目的探讨国内112例单纯脾包虫病的发病特点、诊断和治疗。方法检索国内1994-2005年间的文献,取其资料较完整的105例单纯脾包虫病,结合本组7例,共112例,对其临床资料进行分析。结果本组患者：平均年龄36岁;男性67例,女性45例;囊型脾包虫110例,泡型脾包虫2例;单囊型89例,多囊型23例。左上腹隐、胀痛及包块、脾大为主要临床表现,多为超声、CT检查发现。67例行脾包虫内囊摘除术,19例行脾脏切除术,其余不详。作随访的43例,3例复发,无死亡病例报道。结论单纯脾包虫病多见于青壮年男性,多为细粒棘球蚴,单发囊肿多见,以西北畜牧区农、牧民最多。诊断主要依赖临床表现和超声、CT检查。手术是其主要的治疗措施,微创和保脾是其手术的发展方向。

Objective To study clinical characteristics, diagnosis and treatment of 112 cases single lienal hydatidosis in China. Methods Analysis were made on the clinical data of 112 cases of single lienal hydatidosis from 1994 to 2005, including 105 cases which care from relatively integrated document by searches and 7 cases of this group. Results Among the patients, average age was 36 years old. Sixty - seven patients were males and 45 patients were females. One hundred and ten patients were splenic cystic echinococcosis, two patients were splenic lveolar echinococcosis ; eighty -nine patients were single -cyst, twenty -three patients were multi -cyst. Clinical characteristics were mostly abdominal pain on the top of left, abdominal mass and splenomegaly, patients were almost found by ultrasonic or CT examinations. Sixty - seven patients were put in practice inner cyst extraction of lienal hydatidosis, Nineteen patients were put in practice lienectomy, the rest were not known clearly. After a follow - up of 43 cases, there were 3 cases recurrences, no patients died of the disease. Conclusion Single lienal hydatidosis is a disease with a higher prevalence among prime male of life, splenic cystic echinococcosis accounts for the most shares among patients, and mainly belong to Single - cyst, the most patients occur in farming area of northwest. Diagnosis depends on clinical history, ultrasonic and CT examinations. Surgery is a primary therapeutical measure, therapy of slight trauma and spleen reservation are the developmental direction of surgery.