141例肝泡型包虫病住院病例临床特征分析

发布时间：2018-05-09 06:09

本文选题：肝泡型包虫病 + 肝功能　；参考：《青海大学》2013年硕士论文

【摘要】：目的：探讨青海省肝泡型包虫病的临床特点，分析肝泡型包虫侵及肝脏的部位与各临床特点之间的关系，为流行地区肝泡型包虫病的诊断、临床观察以及治疗等方面提供必要的理论依据和详实的临床资料。方法： 1、收集整理西宁市三甲医院自2006年至2011年期间（6年）入院收治的肝泡型包虫病临床病例。 2、根据影像学检查结果显示，按照包虫病灶位于肝右叶、肝左叶和左右叶均累及，将所收集病例分为A、B、C三组。 3、对A、B、C三组病例资料的临床特征进行回顾性分析。结果：共收集肝泡型包虫病入院病例141例，患者主要表现为右上腹胀痛118例，乏力及消瘦21例，黄疸13例，腹部包块64例，体检发现35例。114例患者接受包虫IgG抗体检查，，27例未做，检查结果中阳性36例，阳性率为36/114。并发其他脏器转移共39例，其中并发脑转移的8例（20%），肺转移12例（31%），脑和肺转移的9例（23%），脑和肾转移的7例（18%），同时并发脑、肺及肾等多个脏器转移的有3例（8%）,以肺转移所占比重最大。141例患者均行腹部CT检查，98例行腹部B超检查。B超、CT等影像学检查表现具有各自特征性，87例包虫病灶位于肝右叶，占61.7%；有23例位于肝左叶，占16.3%；31例侵及肝左右叶，占22%。三组患者之间的谷丙转氨酶指标差异没有统计学意义；三组患者之间的血清总胆红素、血清白蛋白的差异有统计学意义；三组患者并发其他脏器转移率之间的差异存在统计学意义；转移组与非转移组之间病灶大小的差异性没有统计学意义。结论：肝泡型包虫病的临床表现多为右上腹部胀痛；两叶包虫及肝左叶包虫较肝右叶包虫更易并发肝外脏器转移；包虫病灶较小时也可并发其他脏器转移。
[Abstract]:Objective: to investigate the clinical characteristics of hepatic alveolar hydatid disease in Qinghai Province, and to analyze the relationship between the location of hepatic alveolar hydatid disease and the clinical characteristics. Clinical observation and treatment provide necessary theoretical basis and detailed clinical data. Methods: 1. The clinical cases of hepatic alveolar hydatid disease in Xining third Class A Hospital from 2006 to 2011 (6 years) were collected and sorted. 2. According to the results of imaging examination, according to the hydatid foci located in the right lobe of the liver, Zuo Ye and the left and right lobes of the liver were involved, the collected cases were divided into three groups. 3. The clinical features of the three groups of patients were retrospectively analyzed. Results: 141 cases of hepatic alveolar hydatid disease were collected. The main manifestations of the patients were right upper abdominal distending pain 118 cases, fatigue and wasting 21 cases, jaundice 13 cases, abdominal mass 64 cases. A total of 35 cases (114 cases) were examined for hydatid IgG antibody, 27 cases were not tested, 36 cases were positive, the positive rate was 36 / 114. There were 39 cases of other organ metastasis, of which 8 cases were complicated by brain metastasis, 12 cases by lung metastasis, 9 cases by brain and lung metastasis, and 7 cases by brain and kidney metastasis. Three patients with multiple organ metastasis, such as lung and kidney, were involved in this disease. Among them, the largest proportion was lung metastasis. All of the 141 patients underwent abdominal CT examination and 98 cases underwent abdominal B-ultrasound examination. The imaging findings of B-ultrasound CT and other imaging findings showed that 87 cases of hydatid disease were located in the right lobe of the liver. 23 cases were located in Zuo Ye of liver, 31 cases were involved in the left and right lobe of liver, accounting for 2222 cases. There was no significant difference in the alanine aminotransferase index among the three groups, the difference of serum total bilirubin and serum albumin between the three groups was statistically significant. The difference of metastasis rate between the three groups was statistically significant, and there was no significant difference between the metastatic group and the non-metastatic group. Conclusion: most of the clinical manifestations of hepatic alveolar hydatidosis are right epigastric flatulence, bilobar hydatid and hepatic Zuo Ye hydatid are more likely to be complicated with extrahepatic organ metastasis than right hepatic hydatid, hydatidosis can also be complicated with other organ metastasis when the focus of hydatid disease is small.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R532.32

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