175例晚期肝多房棘球蚴病患者临床特征分析

Clinical characteristics of 175 cases with advanced hepatic alveolar echinococcosis

目的分析晚期肝多房棘球蚴病患者临床特征,为该病诊断及治疗提供参考依据。方法回顾性分析2012-2017年青海大学附属医院确诊的175例晚期肝多房棘球蚴病患者临床特征。结果175例晚期肝多房棘球蚴病患者中,男女比例为1∶1.6;年龄11~69岁,平均(38.6±12.9)岁;患者以藏族为主(164例,占93.7%),主要来自果洛州(139例,占79.4%),职业以牧民为主(129例,占73.7%),文化程度以文盲为主(102例,占58.3%)。患者主要临床症状为上腹部疼痛、皮肤黏膜及巩膜黄染,病灶主要位于左右肝(占69.1%),2个及以上病灶者占63.4%,下腔静脉肝内段受累占53.7%。邻近器官受累以膈肌为主(21.7%),远处转移以肺部为主(占40.6%)。结论青海省果洛州晚期肝多房棘球蚴病患病率较高,应针对该地区人群展开筛查,制定合理治疗方案。

Objective To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis,so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis.Methods The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed.Results Among the 175 cases with hepatic alveolar echinococcosis,the male to female ratio was 1∶1.6,and the mean age was (38.6 ± 12.9) years (range,11 to 69 years).93.7% of the patients (164 cases) were Tibetan, and 79.4%(139 cases) were from Guoluo Prefecture.73.7%(129 cases) were herdsmen,and 58.3%(102 cases) were illiterate. The major clinical symptoms included upper abdominal pain,yellowing of skin and mucosa,and scleral icterus.69.1% of the lesions were located in bilateral livers,and 63.4% of the cases have 2 and more lesions.53.7% of the cases have their inferior vena cava involved by the lesions.In addition,the most affected neighboring organ was diaphragmatic muscle (21.7%),and lung was the most affected distant metastatic site (40.6%).Conclusions Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture,Qinghai Province.Screening of this disease is required in this region and rational treatment scheme should be developed.