肝吸虫感染合并肝内胆管细胞癌诊疗1例报告  

Diagnosis and treatment of clonorchiasis combined with intrahepatic cholangiocarcinoma:a case report

作　　者：李秀秀 彭洁雅 曾丽玲 闫海震[2] LI Xiuxiu;PENG Jieya;ZENG Liling;YAN Haizhen(The First Affiliated Hospital of Jinan University,Guangzhou,Guangdong 510630,China;Guangzhou Red Cross Hospital of Jinan University,Guangzhou,Guangdong 510235,China)

机构地区：[1]暨南大学附属第一医院,广东广州510630 [2]暨南大学附属广州红十字会医院,广东广州510235

出　　处：《中国热带医学》2024年第7期885-888,共4页China Tropical Medicine

基　　金：广东省中医药局科研项目(No.20221302;No.20242066)。

摘　　要：报道1例肝吸虫感染合并肝内胆管细胞癌病例诊疗情况,以提高临床医生对肝吸虫的认识,为临床诊断治疗提供参考。回顾性分析暨南大学附属广州红十字会医院2021年3月15日收治1例肝吸虫感染合并肝内胆管细胞癌患者资料。患者,男,55岁,自述腹胀、纳差2月余,有糖尿病、高血压病史多年,10余年前开始嗜食生鱼片。入院后体检:上腹部剑突下可触及8 cm×8 cm实性包块,表面不平,质地稍硬,活动度差,压痛阳性。实验室检查:粪便常规查见肝吸虫卵,肝吸虫IgG抗体阳性。结合腹部超声、腹部平扫+增强CT等影像学检查后诊断为“肝内胆管细胞癌肝内多发转移”,患者肝功能较差,暂不予应用吡喹酮,改用阿苯达唑10 mg(/kg·d),每天一次,连用7 d。出院后1个月再次入院,粪便常规未查见肝吸虫卵。出院12个月后随访,患者死于肝功能衰竭。肝吸虫感染严重病例较少见,高危人群感染后比较严重,尤其是发展到肝内胆管细胞癌。临床医生应当提高对肝吸虫及所引起感染的认识,尽早发现肝吸虫,予以对症治疗,及早诊断和治疗对于改善患者的预后至关重要。To report a case of clonorchiasis(Clonorchis sinensis infection)combined with intrahepatic cholangiocarcinoma and review relevant literature to improve the awareness of the clinical physicians regarding Clonorchis Sinensis and provide references for clinical diagnosis and treatment.A retrospective analysis was conducted on a case of clonorchiasis combined with intrahepatic cholangiocarcinoma,admitted to Guangzhou Red Cross Hospital of Jinan University on March 15,2021,along with a review of related literature.The patient,a 55-year-old male,presented with abdominal distension and poor appetite for over two months and had a history of diabetes and hypertension for many years.He had been consuming raw fish for more than ten years.Upon admission,physical examination revealed a solid mass measuring 8 cm×8 cm was palpable below the xiphoid process in the upper abdomen,with an uneven surface,slightly hard texture,poor mobility,and positive tenderness.Laboratory tests revealed the presence of Clonorchis Sinensis eggs in the stool,and the patient tested positive for Clonorchis Sinensis IgG antibodies.After a comprehensive evaluation that included abdominal ultrasound,abdominal plain CT scan,and contrastenhanced CT,the patient was diagnosed with"intrahepatic cholangiocarcinoma with multiple intrahepatic metastases."Due to the patient′s poor liver function,praziquantel was not administered,and albendazole was instead used at a dose of 10 mg/(kg·d)once daily for seven days.Upon re-admission one month after discharge,no Clonorchis Sinensis eggs were found in the stool.A follow-up after 12 months revealed that the patient had passed away due to liver failure.The serious infection of Clonorchis Sinensis is relatively rare,but it can lead to severe consequences in high-risk individuals,especially when it progresses to intrahepatic cholangiocarcinoma.Clinicians should enhance their awareness of clonorchiasis and promptly identify and provide symptomatic treatment for infections,as early as possible and provide appropriate tre

关 键 词：肝吸虫 肝内胆管细胞癌 多发转移 

分 类 号：R532.23[医药卫生—内科学]