Hepatic paragonimiasis:a single-center retrospective analysis of 32 cases in China's Mainland  

肝吸虫病:中国内地单中心32例回顾性分析

作　　者：Xiwen Ye Xianze Xiong Nansheng Cheng Jiong Lu Yixin Lin 

机构地区：[1]Department of Bile Duct Surgery,Sichuan University West China Medical Center,Chengdu,Sichuan,China

出　　处：《Gastroenterology Report》2017年第4期282-287,I0002,共7页胃肠病学报道（英文）

基　　金：National Natural Science Foundation of China(Grant No.30772124);Sichuan Provincial Health and Family Commission of Science and Research Fund(Grant No.16ZD010).

摘　　要：Background:In paragonimiasis,the lungs and pleural cavity are the major target organs,and the central nervous system can also be affected.The liver is an organ in which ectopic paragonimiasis rarely occurs.Because the symptoms and examinations in hepatic paragonimiasis(HP)are not typical,the disease is often misdiagnosed in the clinic.Methods:From February 2008 to March 2015,our department accepted 32 patients who presented with a liver mass upon ultrasound and computed tomography imaging and in whom the source of the mass could not be identified upon numerous further diagnostic tests.We ultimately obtained surgical biopsies of their lesions for pathological examination.We analysed the clinical data of these cases,along with their disease characteristics,the diagnostic strategies employed and their treatment experiences.Additionally,we performed patient follow-up for a period of 6–12 months.Results:All patients underwent half/partial hepatectomy and were diagnosed with HP upon pathological examination.They recovered well after surgery and their original symptoms were markedly improved without recurrence.The liver functions of the patients reached normal levels before discharge and no additional liver lesions were found upon diagnostic imaging.Conclusion:The diagnosis of HP based on clinical manifestations,laboratory tests or image examination is difficult and only pathologic analysis of biopsies could confirm HP.Surgical treatment not only removes lesions,but also allows for pathologic biopsy.This study encompasses the largest number of HP patients to date,but the surgical outcomes require further research and long-term follow-up.背景:肺和胸腔是吸虫病的主要受累器官,此外,中枢神经系统也时有感染。肝是异位吸虫病极少累及的器官。由于肝吸虫病的症状和检查结果不典型,该病在临床上常被误诊。方法:2008年2月至2015年3月间,本中心收治了32例经超声和CT发现的肝肿块患者,经多项进一步检查,肿块来源仍无法明确。我们最终行外科手术切除并将组织标本送病理检查。我们对这些病例的临床资料进行分析,并对疾病特征、诊断策略及治疗经验进行了总结。此外,我们还对这些病伤残进行了612月的随访。结果:所有病例均行半肝或部分肝切除术并最终经病理诊断为肝吸虫病。术后均恢复良好,症状显著改善,无一例复发。出院前肝功能均达到正常水平,影像学检查亦未发现任何其他肝脏病变。结论:基于临床表现、实验室检查及影像学检查难以诊断肝吸虫病,组织标本病理检查是惟一确诊肝吸虫病的手段。外科手术不仅可以切除病变,而且可以提供病理标本。本研究是至今最大例数的肝吸虫病报道,但手术疗效需进一步研究和更长期的随访。

关 键 词：hepatic paragonimiasis parasitic disease diagnostic strategies hepatic resection 

分 类 号：R73[医药卫生—肿瘤]