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	骨包虫病的诊断及治疗
其他题名	Treatment and diagnosis of bone hydatid disease
	刘大鹏 1; 谢增如 2; 张锐 3; 金格勒 2; 田征 2; 赵国庆 4
来源期刊	中华骨科杂志
ISSN	0253-2352
出版年	2004
卷号	24 期号:7 页码:403-407
中文摘要	目的回顾性分析骨包虫病的临床表现和X线征象,探讨其诊断、鉴别诊断及治疗方法。方法自1957年10月～2004年2月收治的骨包虫病患者37例,男16例,女21例。年龄14～58岁,平均29岁。病史0.5～12年,平均3.1年。发病部位:颈椎2例,肩胛骨1例,胸椎11例,肋骨2例,腰椎5例,髂骨1例,骶骨6例,耻骨1例,髋关节2例,股骨转子间1例,股骨上段2例,胫骨上段1例,肱骨头1例,桡骨上段1例。所有患者均采用手术治疗,以病灶清除为主,部分患者行自体骨、异体骨、人工骨或骨水泥填塞。术后口服阿苯达唑(片剂或原粉每日20mg/kg;阿苯达唑脂质体每日10mg/kg)3个月,预防复发。结果25例行皮内Casoni试验,阳性21例(84%)。4例行包虫病八项免疫试验,均为阳性。21例行MR检查,18例诊断为骨包虫病。24例获随访者,随访时间2~20年,平均3.6年。11例复发(45.83%),其中胸椎4例,腰椎2例,骶骨4例,髋关节1例。6例四肢骨包虫病患者未见复发。24例脊柱骨包虫病患者中16例有神经系统损害,Frankel分级A级1例,B级3例,C级3例,D级9例,所有病例术后均有不同程度改善。结论骨包虫病好发于躯干骨,尤其是脊柱。其影像学表现与结核、转移癌、骨巨细胞瘤、骨囊肿等相似,应注意鉴别。MRI有助于脊柱包虫病的诊断,血清学检查是诊断骨包虫病的主要方法;脊柱包虫病伴脊髓压迫采用手术治疗症状改善明显,但病灶不易清除彻底,容易复发。
英文摘要	Objective To analyze the diagnosis and treatment of bone hydatid disease retrospec-tively. Methods From October 1957 to February 2004, thirty-seven consecutive cases, which were 16 males and 21 females, underwent debridement operation. The average age was 29 years ranging from 14 to 58 years. The history of bone hydatid disease was 3.1 years ranging from 0.5 to 12 years. The lesion was lo-cated at cervical vetebrae in 2, scapula in 1, thoracic vetebrae in 11, rib in 2, lumbar vetebrae in 5, ilium in 1, sacrum in 1, pelvic pubis in 1, hip joint in 2, femoral intertrochanter in 1, proximal humerus in 2, proxi-mal tibia in 1, humeral head in 1, and proximal rudius in 1, The lesions of all cases were performed curet-tage thoroughly accepted and some of them received autogenetic or allogenetic bone graft, and artificial bone or bone cement was used to fill the defect in a few cases. Albendazole was used to prevent relapse for 3 months after operation, the dose of Albendazole tablets or powder was 20 mg/kg per day, or liposomal Al-bendazole 10 mg/kg per day. Results 24 cases were followed up; the period was 2 to 20 years with an av-erage of 3.6 years. Of 37 cases, 31 were hydatid disease of trunk bone (83.78%), 24 were spinal hydatid disease. 25 of 37 cases were performed Casoni test, 21 oases were positive(84%). Four cases accepted the 8-tests immunodiagnosis for human hydatidosis, all were positive. MRI examination was taken in 21 of 37 cases, 18 cases were diagnosed as bone hydatid disease. In 24 cases which were followed up, 11 cases re-lapsed (45.83%). Conclusion Bone hydatid disease often occurs in the bone of trunk, especially in spine; the X-ray or CT images of bone hydatid disease are similar to tuberculosis, metastases, giant cell tumor, or cyst of bone, it should be identified with these diseases; MRI is valuable to diagnosis of spinal hydatid dis-ease; serological examinations are the major method of identification diagnosis; spinal hydatid disease can not be eliminated easily by operation, and often relapses.
中文关键词	棘球蝴病 ; 骨 ; 诊断 ; 骨科手术方法
英文关键词	Echinococoosis Bones Diagnosis Orthopedic procedures
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:1666537
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/205823
作者单位	1.新疆医科大学第一附属医院骨科, 乌鲁木齐, 新疆 730000, 中国; 2.新疆医科大学第一附属医院骨科, 乌鲁木齐, 新疆 830000, 中国; 3.新疆建功医院放射科; 4.新疆精河县医院骨科
推荐引用方式 GB/T 7714	刘大鹏,谢增如,张锐,等. 骨包虫病的诊断及治疗[J],2004,24(7):403-407.
APA	刘大鹏,谢增如,张锐,金格勒,田征,&赵国庆.(2004).骨包虫病的诊断及治疗.中华骨科杂志,24(7),403-407.
MLA	刘大鹏,et al."骨包虫病的诊断及治疗".中华骨科杂志 24.7(2004):403-407.