背景:包虫病是世界范围内最严重的寄生虫人畜共患病之一。肺是第二个最常见的包虫病部位。本研究旨在评估临床状况,诊断,治疗,以及三级肺中心患者的肺包虫囊肿的放射学发现。
方法:从2014年4月至2019年7月,患者转诊至MasihDaneshvari大学医学中心,其印象为肺泡包虫病。收集了304例患者的人口统计学数据,包括临床症状,实验室研究,放射学发现,肺部受累的位置,和囊肿特征。此外,外科手术,医疗,记录术后并发症。
结果:234例患者确诊为肺包虫病。55%的患者为男性,平均年龄为45.1±16.6岁。最常见的症状是咳嗽(59.8%),呼吸困难(31.1%),咯血(26%)。左肺,右肺,据报道,双边参与占40.1%,55.1%,和4.8%的病例,分别。囊肿穿孔(39.8%)是最常见的术中发现。手术干预包括开胸手术,硬质支气管镜检查,囊肿抽吸术,和摘除。由于肺包虫病,肝脏是最伴随的器官(16.6%)。术后最常见的并发症是肺不张,率为35.7%。52.2%的患者术后10天内出院。没有死亡报告。
结论:有时在不同的影像学表现中的不典型表现使包虫囊肿的诊断具有挑战性。尽管肺叶受累超过50%有肺叶切除术的指征,我们保留了大约70%的人参与我们的机构,患者无术后并发症。
BACKGROUND: Hydatidosis is one of the most critical worldwide parasitic zoonotic diseases. The lung is the second most common site of hydatidosis. This study aimed to evaluate the clinical status, diagnosis, treatment, and radiological findings of pulmonary hydatid cyst in patients referred to tertiary lung center.
METHODS: From April 2014 to July 2019, patients referred to Masih Daneshvari University Medical Center with the impression of alveolar hydatidosis included. Demographic data of 304 patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and cyst characteristics. Also, surgical procedures, medical treatments, and post-operative complications were recorded.
RESULTS: Pulmonary hydatidosis was confirmed for 234 patients. 55% of patients were males with the mean age of 45.1±16.6 years. The most common symptoms were cough (59.8%), dyspnea (31.1%), and hemoptysis (26%). Left lung, right lung, and bilateral involvement were reported in 40.1%, 55.1%, and 4.8% of cases, respectively. Cyst perforation (39.8%) was the most common intra-operative finding. Surgical interventions included thoracotomy, rigid bronchoscopy, cyst aspiration, and enucleation. The liver was the most concomitant organ involved due to pulmonary hydatidosis (16.6%). The most common postoperative complication was atelectasis, with the rate of 35.7%. 52.2% of patients were discharged within 10 days after surgery. No mortality was reported.
CONCLUSIONS: Sometimes atypical findings in different imaging modalities make the hydatid cyst diagnosis challenging. Although lobe involvement more than 50% has the indication for lobectomy, we conserved lobes with about 70% involvement in our institution, and patients had no postoperative complications.