非牧区肝包虫病的诊断与治疗

DIAGNOSIS AND TREATMENT OF LIVER HYDATIDOSIS IN NONPASTURELAND

目的 探讨非牧区肝包虫病的诊断与治疗。方法 对我院 1983年 5月至 1999年 5月期间收治的 16例肝包虫病进行回顾性分析。结果 16例患者中只有 8例有临床症状和牧区生活接触史 ,所测 10例患者的Casoni试验及间接血凝集试验的敏感性均为 90 % ,CT检查的诊断准确率 (5 /10 )明显高于B超检查的诊断准确率 (3/14 )。手术治疗 15例 ,效果良好 ,无手术死亡、过敏性休克及播散种植发生。结论 对肝包虫病的充分认识及警惕是早期诊断和正确处理该病的关键 ,同时应结合Casoni试验和间接血凝集试验 ,以及B超和CT检查综合分析 ,以尽早明确诊断。外科手术是肝包虫病的主要治疗方法 ,术中应遵循“无瘤手术”原则 ,消灭囊腔 。

Objective To investigate the diagnosis and treatment of the liver hydatidosis in nonpastureland. [WT5”HZ]Methods [WT5”BZ]Clinical features of 16 patients with liver hydatidosis were analyzed retrospectively. [WT5”HZ]Results [WT5”BZ]Only 8 of 16 patients possessed the clinical symptoms and 8 patients had had history of inhabitancy in epidemic area. Casoni test and indirect hemagglutination showed a sensitivity of 90% and the correct diagnostic rate of CT was higher than that of B ultrasound examination. The main effective treatment of the liver hydatidosis was surgical, 15 out of 16 patients received surgical treatment. In this series, the curative effect was good without any death, allergic reaction and implantation. [WT5”HZ]Conclusion [WT5”BZ]The cystic lesion of liver should be considered as liver hydatidosis and Casoni test, indirect hemagglutination, together with CT and B us examination can be used to comfirm the diagnosis though no clinical symptoms and history of inhabitancy in epidemic area presented. Surgical operation is the main effective treatment for liver hydatidosis.