147例包虫病手术病例分析

１４７例包虫病手术病例分析包头医学院（包头０１４０１０）白华民俞惠敏闫艳锡林郭勒盟医院五星徐秀荣锡林郭勒盟位于内蒙古中部，是包虫病流行较重的地区，包虫病手术病例占内蒙中西部的６０．０７％［１］。近年养犬日益增多，加之牧民用家畜脏器喂犬，造成人畜间包虫...     

卵巢包虫病一例报告

细粒棘球蚴发生的包虫囊,以肝脏为最多见,其次为肺部和其它部位。骨盆器官的继发性包虫囊病较常见,但原发性的极为少见。本文报告一例罕见的卵巢原发性包虫病。患者是伊朗马什哈德的一名经常接触家畜和犬的农村妇人,年60岁。在15年前,该妇人阴道内开始有一肿块,最近除排尿非常     

2017-2019年西藏那曲市包虫病综合防治效果分析

目的了解和分析西藏自治区那曲市包虫病流行现状和势态,评估2017-2019年综合防治效果,为制订包虫病防治对策提供科学依据。方法收集那曲市辖区内各流行县(区)2017-2019年包虫病综合防治联合评估数据并与2012-2016年流调数据作比较,分析2017-2019年那曲市包虫病综合防治效果。采用SPSS22.0软件进行统计学分析,率的比较采用χ~2检验。结果那曲市2019年人群包虫病患病率为0.54%(2 533/466 732),较2016年的3.37%(15 565/462 381)显著下降(χ~2=43.00,P0.05);2019年犬棘球绦虫感染率为2.28%(67/2 941),较2016年的11.36%(128/1 127)显著下降(χ~2=208.00,P0.05)。标化后犬感染率为1.72%,各县标化感染率均有不同幅度的下降;2019年家畜包虫病患病率为0.06%(26/43796),较2016年的5.74(21/366)明显下降(χ~2=63.00,P0.05)。2019年人群包虫病防治相关知识知晓率为98.64%(16 322/16 547),较2016年的31.01%(824/2 657)显著升高(χ~2=1 348.00,P0.05)。结论那曲市2017-2019年包虫病综合防治效果显著,人群包虫病患病率、犬感染率、家畜患病率均显著下降,人群包虫病相关知识知晓率提高。     

新疆阜康市包虫病流行病学调查与防治技术研究

目的了解新疆阜康市包虫病患病和感染状况,掌握流行动态,为修正防治措施、提高防治效益提供基数资料。方法 2009年采取整群抽样方法,对农牧民进行腹部B超检查和学生血清学检测,确定农牧民包虫病患病率和学生感染率;用粪抗原检测法调查家犬细粒棘球绦虫感染率;通过问卷调查方法了解居民养犬状况和知识知晓率。结果阜康市农牧民包虫病患病率为0.10%（10/10 170）;学生感染率为2.8%（26/927）;家畜感染率为15.54%;犬感染率为4.23%;农牧民知识知晓率达10%,学生知识知晓率达37.9%。结论居民包虫病感染率和患病率较高,与犬的密切接触、犬未驱虫、环境卫生差和不良的生活习惯、健康知识缺乏等因素有关。     

2010～2012年新疆巴里坤县棘球蚴病调查分析

目的了解新疆巴里坤县人群包虫病患病情况,为预防控制该病提供科学依据。方法以乡（镇）为单位,按农区、牧区、半农半牧区和城区对成人进行B超检查,6～12岁儿童采集血清检测包虫病特异性抗体,采集犬粪检测犬粪抗原调查犬的感染情况,采用观察法和触摸法调查家畜感染情况。结果成人包虫病患病率0．15％,6．12岁儿童血清阳性率4．98％,犬感染率0．77％,家畜感染率3．00％。结论新疆巴里坤县成人包虫病患病率农区高于牧区,儿童血清学阳性率高于全国平均水平,巴里坤县包虫病防治工作任重道远,健康教育促进在包虫病防治工作中占有重要地位。     

海拔4500米高原骨包虫病一例

包虫病流行于世界上畜牧业发达的国家，在我国西北部广为流行。我院曾收治包虫病７２０例，骨包虫病仅一例。患者，女，６０岁，藏族牧民。因左下肢肿痛１年、不能行走２ｄ，于１９９６年６月１３日以“左下肢病理性骨折”住院。患者久居牧区，与犬有密切接触史，２０年前...     

24例膈肌包虫病的外科治疗报告

1　临床资料2 4例患者中男 12例 ,女 12例 ,年龄 12～ 57岁 ,平均 2 7.2岁 ,均来自包虫病流行区 ,有犬接触史 ,病程14天～ 2年。并发肝包虫病 10例 ,并发肺包虫病 4例 ,并发纵隔胸膜包虫病 2例 ,穿入肺形成支气管瘘 2例 ,破入胸腔感染形成脓胸 1例 ,膈肌单纯包虫病 5例。2　临床症状及体征均有右上腹部或右胸部持续性隐疼。发热、咳嗽咯痰 11例 ,咳水样物 2例 ,咯血 1例。既往肝包虫病手术者 15例 ,肺包虫病手术者 2例 ,皮肤荨麻疹者 4例。右侧胸廓膨隆并呼吸运动度不同程度减弱者 16例 ,右侧胸部语额减弱叩实音者 2 0例。右肺中下叶闻及罗…     

青海省泽库县包虫病流行病学评价报告

2000年6－9月对青海省泽库县境内人、家畜和野生动物感染包虫病情况进行了调查,共检查1046人,确诊囊型包虫病77例,泡型包虫病3例;女性包虫病感染率和患病率均高于男性,牧民病例数最多,患病率也较高;包虫病的感染率和患病率在年龄分布中有随年龄增长而逐升的趋势;泽库且绵羊、牦牛、高原鼠兔和灰尾兔有多房棘球蚴的感染,感染率分别为5．36％、4．69％、3．45％和12．50％;共剖检无主犬12只,5只感染细粒棘球绦虫,1只感染多房棘球绦虫。结果表明泽库县包虫病流行十分严重,是两型包虫病并存的混合流行区。     

新疆察布查尔县家畜和犬细粒棘球绦虫感染情况调查

目的了解新疆察布查尔锡伯自治县家畜包虫病的流行现状和家／牧犬细粒棘球绦虫感染情况。方法2011。2013年在该县家畜定点屠宰场对剖检牛、羊进行肝、肺组织感染棘球蚴（包虫）情况调查,用双抗夹心ELISA法检测家／牧犬粪抗原的细粒棘球绦虫感染情况。结果2011～2013年犬细粒棘球绦虫阳性率分别为8．75％（21／240）、4．58％（11／240）和5,83％（14／240）;2012。2013年家畜细粒棘球绦虫阳性率分别为11．0％（33／300）和19．3％（58／300）。结论2011～2013年调查结果表明,该县均有家畜感染棘球蚴和犬感染细粒棘球绦虫,存在犬与牛／羊之间循环的传播链;家畜棘球蚴感染率逐年偏高,并且有上升趋势;但犬的细粒棘球绦虫感染率态势不定,提示该地区包虫病防控工作仍需改善和加强。     

国内包虫病免疫诊断技术进展

包虫病是由棘球属缘虫的续（后）绦期引起的具有地方流行性和自然疫源性的人畜（兽）共患寄生虫病。我国据建国以来的初步调查证实，在ZI个省（市、区）有人和动物原发性包虫病存在，其流行区域占国土总面积的SO／以上，高发区占件％。又据新疆、青海、甘肃、宁夏、西藏、四川等省（区）的调查，人群平均患病率为2％，部分地区高达5％～IO％。家畜群的感染更为严重，野生动物感染也屡见不鲜。目前，用于包虫病诊断的技术手段，有临床学、免疫学、影像学等。其中免疫诊断技术具快速、敏感、特异、价廉等优点，因此，被广泛应用于该病的临…     

以家犬驱虫为中心的棘球蚴病控制措施在新疆两县的应用

目的 通过新疆呼图壁县和温宿县区域试验,验证以家犬(包括牧犬）驱虫为中心的棘球蚴病控制措施的可行性和控制效果。 方法 1987-1990年在新疆呼图壁县和1990-1994年在新疆温宿县分别建立棘球蚴病控制试验区,采用消灭病原以阻断循环链的控制策略,即“犬犬驱虫、 月月投药”的措施,对试验区所有家犬用吡喹酮药饵剂型进行预防性驱虫。实施控制措施后,每年在试验区检测犬的细粒棘球绦虫和绵羊的棘球蚴感染率,以评价驱虫效果。 结果 经过连续3~4年实施“犬犬驱虫、月月投药”措施,呼图壁县和温宿县的家犬细粒棘球绦虫平均感染率分别从实施前的18.5%和14.7%降为0;两县新生绵羊的棘球蚴平均感染率比控制模式实施前降低了85%以上。 结论 以家犬驱虫为中心的策略,即“犬犬驱虫,月月投药”的措施对控制家犬的棘球绦虫病和绵羊的棘球蚴病是有效可行的。     

Hydatid disease of the spine: A survey study from Turkey

Summary Spinal hydatid disease is rare, even in rural areas where echinococcosis is endemic. Although the liver and lungs are commonly involved, spinal hydatid disease, either primary or secondary, represents an uncommon but significant manifestation of the disease. This survey study reviews 28 reports of spinal hydatid disease from Turkey during the past 5 decades. Only 14 patients also had pulmonary or some other organ infestation. The cysts affecting the spine were commonly in the thoracic region. Most patients had intraspinal extradural hydatid cysts associated with vertebral involvement. The presenting symptoms were mostly atypical, and it was interesting that most of the patients were misdiagnosed preoperatively as Pott's disease during the first decades, suggesting that new imaging techniques such as CT and MRI are the diagnostic procedures of choice for this disease. Surgery remains the best therapy for spinal hydatid disease, although adjuvant antihelminthic therapy may be necessary. There were only 15 cases of recurrence (18%); surgical intervention was palliative in all these patients and it was followed by chemotherapy. Operative mortality was very low (two patients died in the early postoperative period) and there were no complications related to treatment with antihelminthic drugs. The study indicates that hydatid disease should be considered in the differential diagnosis when radiological findings suggest spinal infections or tumors, and that surgical decompression in association with chemotherapy is the treatment of choice.     

青海省共和县包虫病流行病学调查

为查明青海省共和县包虫病的流行现状、分布特征及其影响因素 ,用卡松尼皮内试验 ( ID)、间接红细胞凝集试验( IHA)、酶联免疫吸附试验 ( EL ISA)和 B超检查人群包虫病的感染与患病情况 ;用剖检观察触摸法检查家畜棘球蚴病的感染情况 ;用氢溴酸槟榔碱口饲导泻法检测家犬细粒棘球绦虫 ( Echinococcus granulosus,缩写为 Eg.下同 )的带虫情况。结果显示 ,ID、IHA、EL ISA检查阳性率依次为 12 .14%、4.0 4%和 4.6 5 % ,人群囊型包虫病患病率为 2 .6 7% ,藏族居民的囊型包虫病患病率显著高于汉族 ;绵羊和牦牛的棘球蚴感染率分别为 6 2 .91%和 46 .15 % ,母绵羊的棘球蚴感染率显著高于羯绵羊 ;家犬的 Eg.带虫率为 36 .0 0 % ,牧业点犬的 Eg.带虫率显著高于农业点和乡镇居民点。提示该地区为包虫病高发流行区 ,积极推行控制包虫病流行措施十分必要     

新疆包虫病流行病学基线的调查研究——Ⅱ.家犬和绵羊中细粒棘球绦虫感染

在新疆十二个代表性地区于进行人群血清学调查的同时,用剖检法调查家犬细粒棘球绦虫成虫感染率,用屠宰场调查法检查绵羊细粒棘球蚴感染水平。调查结果表明,在新疆各地的家犬和绵羊中都有细粒棘球绦虫的感染存在。 家犬成虫感染率以西部和中部天山牧区为最高(巴音布鲁克71.43％;特克斯69.57％)。塔里木盆地荒漠农业区最低(巴楚10.60％;且未6.90％)。 绵羊包虫病亦以天山牧区最高(80％以上),塔里木盆地绿洲和荒漠农业区最低(喀什市14.1％;巴楚12.18％;且未3.25％)。绵羊患病率随年龄的增长而上升,最高可达90％以上。南疆的喀什、和田地区绵羊患病率低而家犬成虫感染率高,可能是由于牛的包虫病患病率高造成的。在包囊发生部位上,天山牧区西、北天山区域以肝包虫占主要地位,肺包虫比例最低。中部天山区域肺包虫比例略有上升。南天山牧区肺包虫的比例较高。而塔里木南缘与东昆仑山和阿尔金山有牧业连系的且未县,绵羊肺包羊竟占85.71％。作者认为对脏器的趋性不同可能反映了不同虫株的生物学特征。讨论了流行程度的划分问题。建议应以人群血清学调查结果为主,结合家犬和绵羊的感染水平进行划分为宜。提出了划分不同程度地方性流行区的参考标准。     

Development of Em18-immunoblot and Em18-ELISA for specific diagnosis of alveolar echinococcosis

Extensive experience has documented that Em2(plus)-ELISA, Em10-ELISA and Em18-immunoblot and Em18-ELISA are reliable serologic methods for detection of alveolar echinococcosis (AE) caused by the metacestodes of Echinococcus multilocularis. Among these, tests based on detection of antibodies to the specific Em18 antigen, either immunoblot or ELISA, appears to be the most specific for AE. Between 90 and 97% of AE cases with characteristic hepatic lesions detectable by image analysis have been positive in Em18-serology. In contrast Antigen B (8 kDa)-immunoblot is the most sensitive for all forms of echinococcosis, although it can not differentiate AE from cystic echinococcosis (CE). Primary serologic screening for echinococcosis, especially for CE using hydatid cyst fluid of Echinococcus granulosus appears to be highly sensitive in endemic areas. Glycoproteins (GPs) purified from cyst fluid of Taenia solium are highly specific for diagnosis of T. solium neuorcysticercosis (NCC). Using currently available antigens it is not difficult to differentiate these three larval cestodiases serologically. We recommend that (1) primary screening of CE in endemic areas should be carried out using hydatid cyst fluid of E. granulosus prepared from cysts in either sheep, human or mouse for immunoblot and from sheep or mouse for ELISA, (2) both primary screening and confirmation of AE in endemic areas should be carried out using Em18-ELISA, Em18-immunoblot or Em2(plus)-ELISA. Serodiagnosis in areas where both AE and CE are endemic, such as in China, should be carried out as a combination of (1) and (2), and (3) serology of NCC should be carried out using GP-ELISA or GP-immunoblot. All samples showing antibody to Em18 are exclusively from echinococcosis cases. There have been no false positive test reactions with sera from other diseases. Strongest Em18 responders are all from patients with AE but some weaker responses may be found in sera of persons with advanced complex lesions of CE. These highly reliable serodiagnostic methods using native, recombinant and synthetic antigens are briefly summarized and experiences with these methods in Japan is reviewed. We believe that use of these specific antigens in screening and confirmation programs for AE in Japan will improve specificity and reduce the confusion, anxiety and expense in persons whose sera give false positive reactions with crude echinococcal antigens.     

新疆包虫病流行病学基线的调查研究——I.人类包虫病的血清流行病学调查

1984～1989年期间,应用ELISA和IHA两种血清学方法,在新疆十二个有代表性的地区进行居民血清流行病学调查的结果表明,在新疆全境均有包虫病的感染存在。根据居民血清ELISA阳性率,参照家犬细粒棘球绦虫成虫感染率和绵羊细粒棘球蚴感染状况,可将全区划分为三种不同程度的地方性流行区。天山、阿尔泰山和昆仑山区域的牧业和农牧业区居民的血清阳性率在20％以上,属于重度地方性流行区。准噶尔盆地和塔里木盆地的绿洲农业地带包括荒漠牧场,居民血清阳性率在10％以上,属于中度地方性流行区。帕米尔高原的塔什库尔干和塔里木盆地东南缘的一些干旱农业区居民血清阳性率在10％以下,属于轻度地方性流行区。作者认为在流行程度的划分上,不能单纯以血清阳性率而定,还应考虑到家犬和绵羊的感染程度。血清IHA的阳性率大致与ELISA结果相关。但南疆地区居民血清IHA阳性率极低,不与ELISA结果相关。不同民族血清阳性率不同,同一民族在不同地区之间也有明显差异。女性的阳性率高于男性。在血清阳性率的年龄分布上,南北疆不同。北疆居民血清阳性率的高峰在10～14岁年龄段,而南疆在20～24岁年龄段。由血清阳性率反映的包虫病感染的相对危险性以从事游牧生活的地区最高。作者讨论了这些现象的原因。     

Hydatid cyst, an unusual cause of spontaneous hemothorax and diagnostic thoracoscopy: case report

Hydatid disease is a common parasitic disease in areas where sheep and cattle are raised and is currently endemic in the eastern and southwestern parts of Turkey. Patients with hydatid cysts typically present with cough, chest pain, dyspnea, hemoptysis, or allergic reactions. When ruptured, these cysts may cause hemoptysis, dyspnea, and hydatid thorax. Previously published series of cyst hydatid have reported cyst hydatid rupture and hemothorax secondary to trauma, but nontraumatic hemothorax due to spontaneous rupture of hydatid cyst has not been defined. We discuss the clinical features of a patient with no history of trauma who presented to the emergency department with hemoptysis and dyspnea and was found to have hemothorax due to spontaneous rupture of the hydatid cyst on videothoracoscopic investigation and underwent thoracotomy for hydatid disease treatment.     

Review of cases with cystic hydatid lung disease in a tertiary referral hospital located in an endemic region: a 10 years' experience

BACKGROUND: Echinococcus disease is endemic in sheep-and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Turkey. OBJECTIVE: To determine the presentation, approach to surgical treatment and outcome of hydatid disease in an endemic region. METHODS: From January 1989 to December 1998 288 patients, aged between 1 and 71 years with a mean age of 31 years (134 female, 154 male), were operated on for pulmonary hydatidosis. Clinical charts of the patients were reviewed retrospectively in a tertiary referral hospital. RESULTS: Of 288 patients, 30 patients were asymptomatic, the rest (89%) were symptomatic, cough and chest pain being the most common symptoms. Fifty-three patients (18%) had associated liver hydatid cysts. Bilateral lung hydatid cysts were present in 18 patients (6%). Recurrent hydatid cysts were observed in 33 patients (11%). Seventy-seven patients (27%) presented with complicated hydatid cysts. Postoperative morbidity was observed in 3 patients [bronchopleural fistula (2), infection of the cyst space (1)] and postoperative mortality in 1 patient who presented with hydatid lung disease associated with liver and brain cysts. In the remaining 98. 6%, no complications were noted. CONCLUSIONS: In conclusion, hydatidosis is still an important public health problem in Turkey and in an endemic country such as Turkey hydatid lung disease should be considered initially in a patient presenting with a corresponding chest roentgenogram and a compatible epidemiologic history. Surgery is indicated in all symptomatic and/or enlarging or infected cysts. When necessary lobectomy or wedge resection can be the procedure of choice. Single-stage combined resection is preferred in hydatid lung disease with associated liver hydatid cysts. Total postoperative complication and mortality rate is low and we recommend a close follow-up of the operated cases to diagnose postoperative recurrence early in its course.     

Epidemiological and clinical aspects echinococcosis in East Iran.

Three hundred and fifty two cases of hydatid disease were diagnosed in a three year study in Eas Iran, where the disease is found frequently in rural areas. Camel meat is consumed in this region. The offal is given to domestic carnivorous animals, for example sheep dogs, and in these circumstances camels could contribute to the cyclozoonotic spread of the disease. Clinical symptoms are briefly mentioned.     

Issues in Clinical Parasitology: The Management of Hydatid Cyst

Echinococcal or hydatid cyst is not commonly seen in the United States; however, two cases were seen within a 6-month period at a southern teaching hospital, and it is endemic in many areas of the world. The causative organism, Echinococcus granulosus, is a tapeworm of dogs; the normal intermediate hosts are hoofed animals. When man becomes infected enlarging cysts in the liver, lung, nervous system, or peritoneum may cause considerable morbidity. While surgery traditionally has been the treatment of choice, in the past few years the usage of high doses of mebendazole has been suggested as a possible alternative. This review describes two cases and the recent literature regarding the use of mebendazole as therapy for hydatid disease.