肾包虫病的诊断及治疗(附17例报告)

目的 探讨肾包虫病的诊断和治疗方法.方法 对1993年2月-2008年12月新疆维吾尔自治区人民医院泌尿外科收治的17例肾包虫病患者资料进行分析.结果 17例患者均有牧区生活史或较长时间与牲畜接触史,包虫3项免疫试验和B型超声检查,CT检查诊断符合率分别约为83.2%、85.0%、94.0%.17例患者中15例术前诊断明确,17例均手术治疗术后口服阿苯达唑,其中2例行肾切除术,4例行手术摘除肾包虫内囊,剩余11例行保留病侧肾脏肾包虫外囊完整切除术.11例肾包虫外囊完整切除术及2例肾切除患者随访均无复发.4例行手术摘除肾包虫内囊患者术后2例复发.结论 流行病学检查、免疫学检查、B超和CT检查是诊断肾包虫病的主要方法.肾切除或肾包虫外囊完整切除术以及术后口服阿苯达唑可有效降低术后复发.     

Hydatid cysts of the liver with concomitant massive peritoneal hydatidosis: a case report

The worldwide distribution of Echinococcus granulosus and its capability to persist in the human organism by causing serious medical and economical damage makes this parasite popular in terms of diagnosis and treatment implementation. Besides the liver as the primary target organ for this parasite, cases of secondary peritoneal hydatidosis are reported. Although rarely, they present with unusual abdominal symptoms with a bizarre presentation on abdominal ultrasound and Computerized Tomography scans. We present a case of a 44 years old male patient with concomitant presence of liver hydatid cysts and massive peritoneal hydatidosis treated with a combination of surgery and postoperative medications. The treatment of peritoneal hydatidosis consists of surgical removal of all the present cysts. In addition, anti-parasitic drugs are recommended to prevent a recurrence. The concomitant presence of liver hydatid cysts and peritoneal echinococcosis can appear as a result of abdominal trauma or iatrogenic spillage during abdominal surgery.     

Bone echinococcosis with hip localization: A case report with evaluation of imaging features

Hydatid disease (HD) is a zoonotic parasitic disease caused by the larvae of Echinococcus. Bone echinococcosis is rare, accounting for 0.5% to 4% of all echinococcosis. We describe a particular case of pelvic echinoccosis. A 29-year-old man initially presents with pain in his left hip for several years. After an accidental fall from a tree, he suffered a fracture of the left acetabulum. X-rays and CT scans showed an osteolytic area of the acetabulum with bony cortical interruption. MR imaging demonstrated extensive area of osteostructural alteration of the iliac wing and the left acetabulum due to multiple cysts with enhancement of the walls after administration of Gadolinium-based contrast agents. A CT-guided biopsy of an osteolytic area was performed with diagnosis of echinococcus cyst. He underwent albendazole therapy and subsequently echinococcus cyst exeresis, bone curettage, and left hip arthroplasty. Twenty-two months after surgery, CT scan showed recurrence of disease. After 4 years and 6 months of chronic therapy CT scan showed an increase in size of the cyst at the site of the disease recurrence. Five years and 4 months after the first operation, a new cyst exeresis and pelvic bone curettage with implant retention was performed. This case report demonstrates that hydatid cysts should be considered as a possible cause for non-specific pelvic pain, especially in endemic locations.     

加样抽滤法斑点免疫试验诊断包虫病

本文应用加样抽滤法斑点免疫实验检测包虫病人血清抗体诊断包虫病。在以羊包囊液1：10和血清1：400稀释度进行试验时，36例包虫病患者血清的阳性率为97．2％；35例其他疾病患者血清和40例正常人血清的假阳性率分别为57％和0％。结果提示此法诊断包虫病具有较高的敏感性与特异性和较好的实用性。