1例肝、肺、脊柱、脑多部位包虫病的临床治疗  

Clinical treatment of a case of multisite hydatid disease of liver,lung,spine and brine

作　　者：王军全 黄春桂 吴璇 马晨旭 曹太见 WANG Junquan;HUANG Chungui;Wu Xuan;MA Chenxu;CAO Taijian(Department of Spinal Surgery,Tianshui First People’s Hospital,741200,China Wang Junquan and Huang Chungui are the first authors who contributed equally to the article)

机构地区：[1]天水市第一人民医院脊柱外科,741200 [2]天水市第一人民医院检验科,741200 [3]青海大学附属医院研究生院2020级研究生队,西宁810000 [4]青海大学附属医院研究生院,2021级研究生队,西宁810000 [5]青海大学附属医院脊柱外科,西宁810000

出　　处：《传染病信息》2023年第2期188-191,共4页Infectious Disease Information

摘　　要：包虫病以肝组织受累较常见,但也可由血液转移至肝外其他组织,如:肺、骨骼及中枢神经系统而致病。而肝外转移发病率低且不宜鉴别,易误诊或漏诊,尤其是出现颅内转移较为罕见,且致残致死率高。本文回顾性分析了1例肝、肺、脊柱多部位包虫病患者的临床治疗过程以及随访结果。该患者以胸背部疼痛、伴双下肢无力行走困难为主要临床表现而就诊。脊柱MRI及CT显示胸椎多椎体骨质破坏并椎间盘感染致胸椎稳定性丧失、继发性椎管狭窄、死骨的形成、坏死物组织压迫刺激脊髓及神经根引起神经症状。入院后在手术条件允许下行后入路胸椎病灶清除、椎管减压植骨融合内固定术,术后规律口服阿苯达唑片,20 mg/kg,1次/d。3个月后患者自行停药。1年后患者出现包虫病肺部转移,2年后出现包虫病颅内转移而再次入院,但患者入院7 d后死亡。Echinococcosis is commonly invaded in liver tissue,but it can also be found in other tissues outside the liver,such as lung,bone and central nervous system.The incidence of extrahepatic metastasis is low,it is not suitable to be identified,and it is easy to be misdiagnosed or missed.In particular,intracranial metastasis is rare,with high disability and fatality rate.This paper retrospectively analyzed the clinical treatment and follow-up results of a patient with multisite hydatid disease including liver,lung and spine.The patient’s main clinical manifestations include back and chest pain,weakness in both lower limbs,and difficulty walking Spinal MRI and CT showed the loss of thoracic stability caused by multivertebral bone destruction and intervertebral disc infection,secondary spinal canal stenosis,the formation of dead bone,compression of necrotic tissue stimulation of spinal cord and nerve roots causing neurological symptoms.After admission,posterior thoracic lesion removal,spinal canal decompression,bone grafting,fusion and internal fixation were allowed under surgical conditions.After surgery,this patient is treated with 20 mg/kg albendazole tablets daily.After 3 months,the patient stopped taking the drug voluntarily.The patient developed pulmonary metastasis of hydatid disease 1 year later and intracranial metastasis of hydatid disease 2 years later and was readmitted to the hospital.However,the patient died 7 days after admission.

关 键 词：包虫病 肝包虫病 肺包虫病 腰椎包虫病 脑包虫病 阿苯达唑 

分 类 号：R531.5[医药卫生—内科学]