骨包虫病临床特点分析

Analysis of the clinical characteristics of osseous hydatid disease

目的：探讨骨包虫病临床特点,为临床诊断和治疗提供方法和依据。方法：回顾性分析26例骨包虫病患者临床资料。结果：患者均行X线常规检查;20例行CT检查,20例行MRI检查,8例行免疫血清学检查。26例患者经手术治疗并行组织病理学检查证实为骨包虫病。首诊误诊15例,误诊率57.69%;复发≥1次者18例,复发率69.23%。18例出现并发症,反复发作并行2~6次手术。3例经手术完整切除后继续阿苯达唑治疗后痊愈,13例病情控制带虫生存,4例放弃治疗,6例失访。结论：骨包虫病症状不典型,易误诊。结合各种诊疗手段、尤其是MRI检查可提高诊断率。该病复发率高,手术治疗可明显改善症状,但不易彻底清除病灶,配合药物治疗可延缓复发时间。

Objective To provide a method and basis for the diagnosis and therapy of osseous hydatid disease by studying its clinical characteristics.Methods The clinical data of 26 cases of osseous hydatid disease were studied retrospectively.Results Plain X-ray examination was performed in 26 patients,CT in 20 cases,MRI in 20 cases,and serodiagnostic test for human hydatidosis in 8 patients.All cases underwent operation and were proved osseous hydatid by histopathologiccal examination.Fifteen cases were initially misdiagnosed（57.69%）.Eighteen cases（69.23%） recurred more than once.Eighteen cases had complications and received operation twice to 6 times.Three cases were cured after operation and albendazole treatment.Thirteen cases lived with disease and the pathogenetic condition had been controlled.Four cases gave up treatment and the other 6 cases failed to be followed up.Conclusion Because of untypical symptoms,osseous hydatid disease is usually misdiagnosed.To combine various methods,especially MRI,can improve the diagnostic rate.Osseous hydatid disease has a high recurrent rate.Operation can relieve the symptoms but can not remove the focus.To combine with medicinal therapy can prolong the interphase of recurrence.