Hand-assisted laparoscopic splenectomy for hydatid cyst

Splenic hydatidosis is a rare condition. We performed a hand-assisted laparoscopic splenectomy for a large hydatid cyst localized in the center of the spleen. We discuss the advantages of the ``helping hand.' Received: 27 September 1996/Accepted: 19 November 1996     

Effect of mebendazole againstEchinococcus granulosus andTaenia hydatigena cysts in naturally infected sheep and relevance to larval tapeworm infections in man

The ability of three treatment schedules of mebendazole to kill well-established hydatid cysts was studied. Pregnant sheep, naturally infected withEchinococcus granulosus and/orTaenia hydatigena, were treated daily with mebendazole at a dose rate of 50 mg/kg body weight for either five days, one month, or three months.At autopsy, seven months after the commencement of treatment, no evidence was found that the 5-day treatment schedule had any damaging effect onE. granulosus cysts. The effects of the one month treatment were equivocal. There was evidence of a damaging effect from the 3-month treatment schedule and protoscoleces were not infective to dogs. NoT. hydatigena cysts survived the 1- and 3-month treatments, but organisms from the 5-day treatment were infective to dogs.These results forE. granulosus in sheep suggest that long-term treatment with mebendazole may be required in hydatid disease in man. The results obtained forT. hydatigena in sheep are discussed in relation to the treatment of cysticercosis fromT. solium in man. Mebendazole showed no untoward effect on the sheep or their lambs.     

黄南州医院126例包虫病临床分析

本文分析了黄南州医院126例囊型包虫病,结呆发病多见于青壮年,其次为中老年;包虫病与从事牧业生产和在牧区生活的人密切相关;病人以藏族、蒙古族多见,而汉族、回族、撒拉族次之;包虫病常见为肝包虫病,其次为腹腔包虫,其他部位的包虫病少见。B赵、X线拍片、卡松尼氏皮内试验与手术证实的包虫囊肿相吻合,但无特异性。在手术过程中加大处理液（甲醛、乙醇、双氧水）的浓度,或在手术前后服用一定的杀包虫药物（如丙硫咪唑）可降低自虫病的复发率,提高治疗效果。     

Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report

The hydatid cyst of the liver is the most common location of hydatid disease. Complications in this form are dominated by superinfection of the cyst and rupture into the bile ducts or the peritoneal cavity. We report the case of a 54-year-old female patient with a hydatid cyst of the liver complicated by a rupture in the gallbladder revealed by urinary symptoms.     

新疆伊犁河谷肝棘球蚴病临床资料分析

目的　探讨新疆伊犁河谷肝棘球蚴病流行病学特点及临床诊治方法。　方法　对 1993～ 2003年伊犁河谷多家医院经手术确诊并治疗的肝棘球蚴病病例进行回顾性分析。　结果　共 2049例肝棘球蚴病患者 ,其中细粒棘球蚴病 1965例占 96% ,泡球蚴病 84例占 4%。所有病例经棘球蚴皮内过敏试验、B超、彩超、X线检查、X线断层照相术 (CT)、磁共振成像术 (MRI)、血清学免疫试验均可确诊。确诊病例经手术治疗2 034例占 99.2 %。其中 ,行肝叶切除术、肝棘球蚴外囊膜内完整切除术、肝棘球蚴囊肿外囊外切除术共 3 0 2例占 14.7% ,无术后复发及并发症。术后服药 (吡喹酮、阿苯达唑、阿苯达唑脂质体 ) 754例占 36.7% ,均有一定疗效。肝棘球蚴病流行病学特点是沿伊犁河谷流行、散布。患者均生活在农牧区 ,均有与牛、羊、狗密切接触史 ,当地各民族人群均有发病 ,女性 1 125例占 5 4%。25～49岁发病率较高为 982例占 48%。 1993-2003年发病率呈逐年下降趋势。　结论　肝棘球蚴病是新疆伊犁地区高发病、多发病 ,沿伊犁河谷流行、散布。应进一步加强病畜管理、改良手术治疗方法 ,积累临床经验。     

全血金标免疫渗滤法快速检测棘球蚴病的现场应用

目的?摇建立一种检测全血标本的棘球蚴病现场快速诊断方法。 方法 制备检测棘球蚴病抗体的全血金标免疫渗滤法（DIGFA）快速诊断试剂盒，以土豆凝集素与全血混合达到快速凝血的目的，并对1 678名流行区健康体检者、38例棘球蚴病患者、52名非流行区健康体检者、40例其他肝肺占位患者做棘球蚴病全血现场诊断试验，评价其作为初筛棘球蚴病普查手段的实际应用价值。 结果 全血DIGFA对1 678份流行区体检者阳性检出率为8.46%，其中肝脏B超及胸部透视阳性检出率为3.04%，对比免疫学检查142例阳性结果和影像学检查51例阳性结果：影像学检查阳性51例中有43例全血DIGFA为阳性，对其余8例影像学检查阳性而全血DIGFA阴性体检者进行16个月随访，经CT检查或病理学检查证实为肝棘球蚴坏死（3例）、肝钙化（2例）、肝囊肿（2例）、肝癌（1例)。而免疫学检查阳性的142例体检者中43例B超为阳性，对其余99例全血DIGFA阳性而影像学检查阴性的体检者进行16个月随访，发现肺部棘球蚴3例（随访仍在继续，数据统计截止到2003年6月）。对临床手术和病理检查确诊的38例棘球蚴病患者的阳性检出率为89.5%，对52份非流行区无狗羊接触史的健康体检者全血血样阳性检出率为0，与40例其他非棘球蚴性肝肺占位疾病（肝囊肿10例、肝血管瘤10例、肝癌10例、肺结核6例、肺癌4例）全血血样无交叉反应。随机抽取各组全血标本190例分别提取全血和血清标本，进行全血DIGFA、血清DIGFA和血清ELISA单盲法检测，三者检测结果差异无显著性(P＞0.05)。 结论 棘球蚴病全血快速诊断试剂盒操作简便和快速，适合普查和流行病学调查。     

包虫病基因重组疫苗的研究

分子生物学技术的快速发展,使基因工程疫苗的研究更加深入。与此种新型疫苗相比传统疫苗已体现出预防效果不够理想,不容易保存,技术难度大,成本高等诸多缺陷。因此,对基因工程疫苗的开拓研究已成为当前疫苗领域的一个热点。本文简要概述了近年来包虫病基因工程疫苗研究现状及其发展前景。     

单克隆抗体Dot-ABC-ELISA检测包虫病人循环抗原

作者用活化生物素标记抗细粒棘球蚴抗原单克隆抗体（ＭｃＡｂ）１Ｄ８，以聚氯乙烯（ＰＶＣ）白色薄膜凹孔板为载体，建立了ＭｃＡｂ－Ｄｏｔ－ＡＢＣ－ＥＬＩＳＡ检测包虫病人循环抗原的方法。测定人源包虫囊液抗原的灵敏度为６ｎｇ／３μｌ样品．９２例确诊包虫病人血清循环抗原检出率为７６．１％（７０／９２），在抗体阳性者中循环抗原检出率为８１．６％（６２／７６），抗体阴性者中检出率为５０％（８／１６）。１００份正常人和１２２份羹虫病等其它寄生虫病人血清，仅１份囊虫病人血清出现交叉反应．测定循环抗原对包虫病人，尤其是血清抗体阴性者的免疫诊断有重要价值．本法简便、快速，适于推广．     

Ultrasound scanning as a screening technique for hydatidosis in developing countries

This study presents new evidence as to the usefulness of ultrasound scanning in field conditions, to screen out hydatidosis in endemic areas, and to compare its detection capability with serological methods. It also intends to demonstrate that for an efficient rural ultrasound screening, neither an experienced ultra sonographer nor expensive and sophisticated equipment is necessary, it can be done by suitably trained personnel (eg, nurse, public health worker), using basic equipment, without public health installations or electricity, thus making it a feasible, simple, fast, and cheap screening method for hydatidosis.