肝细粒和多房棘球蚴混合感染3例

目的探讨肝细粒和多房棘球蚴混合感染患者诊断及手术治疗,为该类患者临床诊治提供经验。方法回顾性分析2017-2018年青海省人民医院诊断为肝细粒和多房棘球蚴混合感染患者的临床资料。结果共确诊3例肝细粒和多房棘球蚴混合感染患者。其中1例经术前CT检查确诊为细粒和多房棘球蚴混合感染,并在术中得到证实;另2例经术前彩超及影像学检查诊断为细粒棘球蚴病,但根据术中病灶形态和术后病理学确诊为细粒和多房棘球蚴混合感染。2例患者行根治性手术治疗,1例探查后仅行肝细粒棘球蚴内囊摘除、外囊次全切除术。结论肝细粒和多房棘球蚴混合感染患者术前易漏诊、误诊,影像学检查联合术后组织病理学检查结果才能最终确诊。肝细粒和多房棘球蚴混合感染患者手术相对复杂、困难,针对不同感染类型患者应采取个体化手术治疗方案。

Hepatic cystic and alveolar echinococcosis co-infections: a report of 3 cases

Objective To investigate the diagnosis and surgical treatment of co-infection with hepatic cystic and alveolar echinococcosis,so as to provide insights into the diagnosis and treatment of these patients.Methods The clinical data of patients with co-infections of hepatic cystic and alveolar echinococcosis in Qinghai Provincial People’s Hospital between 2017 and2018 were retrospectively analyzed.Results Three patients were diagnosed with co-infection of hepatic cystic and alveolar echinococcosis.One patient was diagnosed by preoperative CT scan,and confirmed intraoperatively.The other two cases were diagnosed as cystic echinococcosis by preoperative color ultrasonography and imaging examinations,and were definitively diagnosed as co-infection of hepatic cystic and alveolar echinococcosis by intraoperative examination of the lesion morphology and postoperative pathology.Two patients were given radical surgery,and another case was given removal of the internal capsule and subtotal excision of the outer capsule of Echinococcus granulous in the liver following exploration.Conclusions Co-infection with hepatic cystic and alveolar echinococcosis is easy for missed diagnosis and misdiagnosis prior to operation,and the definitive diagnosis may be made by means of imaging examinations combined with postoperative pathology.The surgery is relatively complicated and difficult for patients with co-infection of hepatic cystic and alveolar echinococcosis,and individualized surgical treatment regimen should be employed for patients with various types of infections.