新疆地区小儿包虫感染564例分析

Analysis of 564 cases with pediatric echinococcosis in Xinjiang region

目的探讨人体包虫病在新疆小儿中的流行与危害，以求有效地防治这一地方病。方法对新疆石河子大学医学院第一附属医院儿科１９６１～１９９５年住院的５６４例小儿包虫病临床资料进行回顾研究。结果年龄最小１岁，最大１５岁，男性３２８例，女性２３６例。占包虫病患者的２３９６％，占住院患者的０．１５％。其中汉族４５４例，维吾尔族４８例，哈萨克族３１例，回族１９例，蒙古族１２例。如以新疆各族居民比例对照，则属以牧业为主的哈萨克和蒙古族的发病比例为最高。患者均系在就诊或体检中分别经Ｘ线、Ｂ超或ＣＴ发现包虫囊肿，之后均做了Ｃａｓｏｎｉ试验进一步确定诊断。证实包虫寄生部位５８３处。８例患者因严重感染不宜手术外，对５５６例患者的不同感染部位进行的５８９次手术转归为：痊愈５３３例，减轻９例，死亡１４例，手术死亡率为２５％。结论人体包虫病在新疆流行甚广，严重地危害着小儿健康。小儿发病率高的原因是他们与包虫的终末宿主———狗较多地以住房为活动中轴，造成了良好的感染机会。治疗以手术为主。

Objective Probimg into the prevalence and harmfulness of human echinococcosis among children in Xinjiang and searching for more effective prevention and treatment of this dieases.Methods A retrospective analysis was made on the clinical data of 564 cases of pediatric echinococcosis, who were admitted to the pediatric medical department from 1961 to 1995. Results Among the patients, the youngest was one year of age and the oldest 15 years; 328 were males and 236 females. They accounted for 23.96% of all echinococcosis patients and 0.15% of all in patients. Of the 564 patients, 454 were of Han nationality, 48 Uygurs, 31 Kazaks, 19 Huis and 12 Mongolians. In contrast to the ratio of various nationalities of Xinjiang residents, Kazak and Mongolian people who mainly go in for animal husbandry had the highest morbidity. All patients were found out at the clinic or on physical exanination. First, echinococcus cysts were found by X ray, B ultrasonic or CT examinations and then confirmed by Casoni′s test. Tolally 583 cysts were localized. It has been well accepted that surgical treatment is the only effective therapy for echinococcosis. In this group, 589 operations were performed on 556 patients except for 8 cases in whom surgery was unsuitable because of severe infection. As a result, 553 patients were cured, 9 were improved and 14 died. The mortality of surgery was 2.5%. Conclusions Human echinococcosis has been prevailing in Xinjiang and seriously harms children′s health. Children have greater chances for being infected as their houses are mostly the axis of their and their dogs′activity. Greater attention must be paid to prevention and treatment of this disease.