Molavipour Alireza, Javan Hadi, Moghaddam Alireza Abdollahy, Dastani Mostafa, Abbasi Mohammad, Ghahramani Sara
Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Iran.
J Card Surg. 2010 Mar;25(2):143-6. doi: 10.1111/j.1540-8191.2009.00973.x.
Echinococcosis is a human parasitic disease common in sheep-rearing regions, which is caused by the larval stage of Echinococcus granolosus and can involve any heart region. We report 11 cases of cardiac hydatidosis who were treated medically and surgically.
Eleven patients diagnosed with cardiac echinococcosis were referred to the Cardiac Surgery Department of Shahid Madani Hospital from 1992 to 2004. Symptoms included dyspnea, palpitation, limb ischemia, fever, weight loss, hemiplegia, and loss of consciousness. Patients underwent surgical removal of the cyst followed by medical treatment until the titer of echinococcus hemaglutination test came to normal.
Hospital stay and recovery time were uneventful in nine patients. One patient died due to acute renal failure before hospital discharge (9%) and another patient experienced cerebral hydatidosis 12 months after surgery (probably due to cyst embolism). The other nine patients had no complications during five years of follow-up.
Surgical excision using cardiopulmonary bypass combined with medical therapy provides the most optimal treatment for cardiac echinococcosis.
棘球蚴病是一种在养羊地区常见的人类寄生虫病，由细粒棘球绦虫的幼虫阶段引起，可累及心脏的任何部位。我们报告了11例接受药物和手术治疗的心脏包虫病病例。
1992年至2004年，11例被诊断为心脏棘球蚴病的患者被转诊至沙希德·马达尼医院心脏外科。症状包括呼吸困难、心悸、肢体缺血、发热、体重减轻、偏瘫和意识丧失。患者接受了囊肿手术切除，随后进行药物治疗，直到棘球蚴血凝试验滴度恢复正常。
9例患者住院和恢复过程顺利。1例患者在出院前因急性肾衰竭死亡（9%），另1例患者在术后12个月出现脑包虫病（可能由于囊肿栓塞）。其他9例患者在五年随访期间无并发症。
采用体外循环的手术切除联合药物治疗为心脏棘球蚴病提供了最优化的治疗方法。
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