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包虫病是新疆地方病,本文指最常见的细粒棘球蚴病。作者1955年10月14日在乌鲁木齐某军区医院成功地摘除新疆首例肺包虫囊肿。一、材料:本院自1957年至1987年连续收住928例胸包虫病人。其中男性63.1％,女性36.9％;年龄3～63岁。50.4％属于肺内单纯型,42.4％胸内复杂型,3.7％胸腹联合型,3.5％为膈下即肝顶部囊肿。二、外科治疗:行内囊摘除术,可先穿刺吸液取出,或不穿刺。后者为内囊完整摘除术即Barrett氏手术。对并发肺部感染或继发支气管扩张症的施行不同切除范围的肺手术。到1985年止已对807例做了1010次各种手术,其中79％内囊摘除术,12％肺切除术,9％引流及其他手术。三、结果:总死亡率0.6％,术后再发4.1％。323例一组进行随访研究3～20年,除有14例晚期死亡外,其余情况良好。14例中11例死于非包虫病,3例死于肝包虫病,无一例死于胸包虫再发。有32例曾住进医院而拒绝手术。随访结果:5例失访,其余27例中6例死于肝包虫病;9例长期咳嗽有“痰”者,X线复查不再见肺内囊肿;5例再次手术;7例仍带病,平均已生存8.1年。四、化学疗法:吡喹酮对狗肠细粒棘球绦虫甚为有效。我们对小鼠试验用吡喹酮,用药的一组形成棘球囊25％;不用药一组70％(P<0.01)。临床上我们对22例用120～210mg/kg,5～6d后,囊液中原头蚴死亡43.1±9.6％至64.2±3.5％。未用药一组为9.2±2.0％(P<0.01)。囊液药物浓度为0.043±0.006μm/kg,而囊壁(湿)含量0.06±0.009％。13例各给予300mg/kg后血浓度0.494±0.075μm/kg。五、结论:无论近期或远期的外科手术都收到良好疗效。吡喹酮对人体肺包虫疗效似不乐观。在目前我仍认为预防和手术是两种处理胸包虫病的方法。
Echinococcosis is a endemic disease in Xinjiang, this article refers to the most common particles of hydatid disease. On October 14, 1955, the author successfully removed the first lung hydatid cyst in Xinjiang from a military hospital in Urumqi. First, the material: The hospital from 1957 to 1987, 928 consecutive cases of chest thoracic patients. Including 63.1% males, females 36.9%; aged 3 to 63 years. 50.4% belonged to simple lung type, 42.4% intrathoracic complex type, 3.7% thoracoabdominal combined type, and 3.5% to subphrenic hepatic top cyst. Second, surgical treatment: intracapsular enucleation, can be punctured aspiration, or not puncture. The latter is a complete removal of the internal capsule that Barrett’s surgery. Lung surgery for concurrent lung infections or secondary bronchiectasis with different resection ranges. By 1985, 1010 surgeries of 807 had been performed on 807 cases, of which 79% were en bloc resections, 12% lung resections, 9% draining and other surgeries. Third, the results: the total mortality rate of 0.6%, 4.1% after the recurrence. A group of 323 cases were followed up for 3 to 20 years, with the exception of 14 cases of late death, the rest in good condition. Of the 14 patients, 11 died of non-hydatid disease and 3 died of hepatic hydatid disease, none of whom died of recurrent thorax. 32 patients had admitted to the hospital and refused to operate. Follow-up results: 5 patients were lost to follow-up, 6 of the remaining 27 patients died of hepatic hydatid disease; 9 patients with long-term cough had “sputum”, X-ray examination no longer seen intrapulmonary cyst; 5 patients underwent reoperation; , Has survived an average of 8.1 years. Fourth, chemotherapy: Praziquantel Euglena granulosus is very effective. We tested praziquantel in mice using a group of spines that formed 25% of the balloon; 70% of the group did not (p <0.01). Clinically, 22 cases of our 120 ~ 210mg / kg, 5 ~ 6d after cystic fluid cysts, the original death of 43.1 ± 9.6% to 64.2 ± 3.5%. The group without medication was 9.2 ± 2.0% (P <0.01). Cystic fluid drug concentration of 0.043 ± 0.006μm / kg, while the wall (wet) content of 0.06 ± 0.009%. Thirteen cases were given 300mg / kg blood concentration of 0.494 ± 0.075μm / kg. V. CONCLUSIONS: Both short-term and long-term surgical procedures have received good results. Praziquantel on human lung hydatid efficacy is not optimistic. At the moment I still think prevention and surgery are two ways to deal with throat echinococcosis.