肾包虫病2例报告

The Reports of Two Cases of Renal Hydatidosis

目的:探讨肾包虫病的临床、影像学特点和治疗方法。方法:回顾性分析2018年04月及2018年10月我科收治的2例肾包虫病患者的临床资料。2例均在全麻下进行手术。一例因左肾上、中、下极肾盏内见大量透明滤泡生长,正常集合系统解剖结构完全破坏,行“左肾切除术”。一例包虫病灶位于右肾中、上极肾实质外侧缘,包膜完整,并突出肾实质表面,囊性占位表面呈钙化状态,行“右肾包虫外囊完整剥除术”。结果:2例患者痊愈出院,术后病理报告均为肾细粒棘球蚴病。术后随访4~9月未复发。结论:肾包虫病临床较少见,多发于少数民族或宗教部落聚居地,地方偏僻且较落后,多数病例临床发现时肾脏实质已完全破坏,迫使医生切除患肾。故加强三级医院医疗资源下沉、对口帮扶义诊以及精准医疗等工作的大力开展,有助于包虫病的早期发现、早期诊断及选择最佳治疗时机,以最大程度上保护残存的肾脏功能。

Objective:To explore the clinical,imaging features and treatment of renal hydatidosis.Methods:The clinical data of 2 patients with renal echinococcosis admitted to our department in April 2018 and October 2018 were analyzed retrospectively.Two cases were operated under general anes-thesia.One case underwent“left nephrectomy”because a large number of transparent follicles grew in the calyx of the upper,middle and lower poles of the left kidney and the anatomical structure of the normal collecting system was completely destroyed.A case of hydatid lesion located at the lateral margin of the renal parenchyma in the middle and upper poles of the right kidney had complete capsule and protruded the surface of the renal parenchyma.The cystic space-occupying surface was calcified.The“complete exfoliation of the right renal hydatid cyst”was performed.Method:The clinical data of 2 patients with renal echinococcosis admitted to our department in April 2018 and October 2018 were analyzed retrospectively.Two cases were operated under gen-eral anesthesia.One case underwent“left nephrectomy”because a large number of transparent follicles grew in the calyx of the upper,middle and lower poles of the left kidney and the anatomical structure of the normal collecting system was completely destroyed.A case of hydatid lesion located at the lateral margin of the renal parenchyma in the middle and upper poles of the right kidney had complete capsule and protruded the surface of the renal parenchyma.The cystic space-occupying surface was calcified.The“complete exfoliation of the right renal hydatid cyst”was performed.Result:Two patients recovered and discharged from hospital.All the pathological reports were renal echinococcosis.No recurrence occurred during the follow-up period from 4 to 9 months.Conclusion:Renal hydatidosis is rare in clinic.It occurs mostly in minority or religious tribes.It is remote and backward.Most cases have been found to have completely destroyed the renal parenchyma,forcing doctors to remove the affected kidney.Therefore,strengthening the medical resources sinking,counterpart assistance,free clinic and precise medical treatment in third-class A hospitals will be helpful to the early detection,early diagnosis and selection of the best treatment opportunity of hydatidosis,and to protect the remaining renal function to the greatest extent.