Objective: To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis, so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis.
Methods: The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed.
Results: Among the 175 cases with hepatic alveolar echinococcosis, the male to female ratio was 1∶1.6, and the mean age was (38.6 ± 12.9) years (range, 11 to 69 years). 93.7% of the patients (164 cases) were Tibetan, and 79.4% (139 cases) were from Guoluo Prefecture. 73.7% (129 cases) were herdsmen, and 58.3% (102 cases) were illiterate. The major clinical symptoms included upper abdominal pain, yellowing of skin and mucosa, and scleral icterus. 69.1% of the lesions were located in bilateral livers, and 63.4% of the cases have 2 and more lesions. 53.7% of the cases have their inferior vena cava involved by the lesions. In addition, the most affected neighboring organ was diaphragmatic muscle (21.7%), and lung was the most affected distant metastatic site (40.6%).
Conclusions: Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture, Qinghai Province. Screening of this disease is required in this region and rational treatment scheme should be developed.
[摘要] 目的 分析晚期肝多房棘球蚴病患者临床特征, 为该病诊断及治疗提供参考依据。方法 回顾性分析 2012–2017 年青海大学附属医院确诊的 175 例晚期肝多房棘球蚴病患者临床特征。结果 175 例晚期肝多房棘球蚴病患者中, 男女比例为 1∶1.6; 年龄 11～69 岁, 平均 (38.6 ± 12.9) 岁; 患者以藏族为主 (164 例, 占 93.7%), 主要来自果洛州 (139 例, 占 79.4%), 职业以牧民为主 (129 例, 占 73.7%), 文化程度以文盲为主 (102 例, 占 58.3%) 。患者主要临床症状为上腹部疼 痛、皮肤黏膜及巩膜黄染, 病灶主要位于左右肝 (占 69.1%), 2 个及以上病灶者占 63.4%, 下腔静脉肝内段受累占 53.7%。 邻近器官受累以膈肌为主 (21.7%), 远处转移以肺部为主 (占 40.6%) 。结论 青海省果洛州晚期肝多房棘球蚴病患病率 较高, 应针对该地区人群展开筛查, 制定合理治疗方案。.
Keywords: Advanced hepatic alveolar echinococcosis; Clinical characteristics; Qinghai Province.