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本文报告1970～1984年28例泡球蚴病,其中21例为甘肃籍,地区分布包括七个县,以漳县病例最多(占13例)。28例中男19例,女9例。20～40岁年龄占67.8％。病程多为1～5年。主要症状是上腹肿块(96.4％),腹痛(39.3％),消化不良(25.0％),黄疸(17.8％)和门脉高压(10.7％)。17例包虫皮试阳性率为94.1％。10例血清甲胎蛋白测定全为阴性。23例病理大体观以巨块型(52.1％)多见,结节型和混合型各占17.4％和30.4％。显微镜下观察显大小不同的无数小囊泡,周围或附近呈纤维结缔组织增生和炎性细胞浸润,形成泡球蚴结节或肉芽肿,增殖方式呈外殖性和内殖性芽生。2例继发肺、脑转移和1例肝门淋巴结转移。22例施行手术探查,仅7例作坏死腔外引流术。19例随访,有5例死于术后6～12月,14例已存活1～8年。12例服用中西药物治疗,其中7例已随访0.5～2.5年,除1例无效外,其余6例均显临床改善。本文还就我省流行特点、诊断、鉴别诊断和治疗作了讨论。
In this paper, 28 cases of alveolar echinococcosis were reported from 1970 to 1984, of which 21 were Gansu nationalities, including seven counties in the region, with the largest number of cases in Zhang County (13 cases). There were 19 males and 9 females in 28 cases. 20 to 40 years of age accounted for 67.8%. Course for more than 1 to 5 years. The main symptoms were abdominal mass (96.4%), abdominal pain (39.3%), indigestion (25.0%), jaundice (17.8%) and portal hypertension (10.7%). The positive rate of hydatidiform epithelial test in 17 cases was 94.1%. 10 cases of serum alpha fetoprotein were all negative. In 23 cases, the majority of pathological findings were found in massive type (52.1%), with nodular and mixed type accounting for 17.4% and 30.4% respectively. Countless small vesicles with different sizes were observed under the microscope. The surrounding or nearby fibrous connective tissue hyperplasia and infiltration of inflammatory cells formed nodules or granulomas of the hydatid cyst. The proliferation mode was exogenous and procambonated. 2 cases of secondary lung and brain metastases and 1 case of hilar lymph node metastasis. 22 cases of surgical exploration, only 7 cases of necrotic extracavitary drainage. 19 cases were followed up, 5 cases died in 6 to 12 months after operation, and 14 cases survived 1 to 8 years. Twelve patients were treated with Chinese and Western medicines. Seven of them were followed up for 0.5-5.5 years. All but one was ineffective, and the remaining 6 patients showed clinical improvement. This article also discussed the epidemic characteristics, diagnosis, differential diagnosis and treatment in our province.