肝泡状棘球蚴病52例临床治疗经验

本文报道由于多房棘球绦虫所致的肝泡状棘球蚴病52例:男35例,女17例,年龄14～52岁,多来自牧区。主要体征为上腹部包块,有黄疸者12例,免疫试验均显阳性,辅助检查如B超、同位素扫描、PTC等提示肝内占位性病变,X片显示特殊钙化点。病例均经手术及病理证实。根治手术5例,术后预后好,8～21年随访无复发。姑息性手术7例亦获改善症状等疗效。13例经长达1～16个月的甲苯咪唑化疗无明显副作用,病情改善,包块缩小,药物剂量较大,疗程较长,治疗效果较好。本文就诊断和治疗方面作简要讨论。

Hepatic Alveolar Hydatidosis Experiences inthe Clinical Treatment of 52 Cases

Fifty-two cases of hepatic alveolar hydatidosis caused by the cestode E. mulitilocularis are reported. There were 35 male and 17 female, aged 14 to 52 years. Main manifestations were firm, round and irregular outline palpated over the right upper abdomen for 2 months to 7 years. Jaundice appeared in 12 of 52 patients. All patients had positive reaction in the Casoni intradermal test and 15 patients had positive reaction at IHA and IEP test. Sonography, Roent-genography and radioisotope liver scan showed space occupying lesions. Surgical radical resection or hemihepatectomy is commonly suggested as the treatment of choicer however, resectability was low and only 5 cases were shown in our series. Most patients were impossible to operate, because the lesions were diffuse or involved both lobes of the liver. Results of surgical therapy were excellent in follow-up 8 to 21 years. 7 patients having palliative resection also showed much improvement of the general condition and relief of the toxic symptoms. 13 patients were treated with mebendazole. The adult dosage was 1200-1500mg daily, divided into 3 doses in 30 days course and repeated at intervals of 1 week to 1 month. One patient who received mebendazole for 16 months with no obvious side effects showed marked improvement and diminution in size of the mass. This suggests that high dosage and long duration mebendazole therapy may be effective.