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[肌肉和皮下包虫病]

[Muscular and subcutaneous hydatidosis].

作者信息

Di Gesù G, Picone A, La Bianca A, Massaro M, Vetri G

出版信息

Minerva Med. 1987 Jun 30;78(12):835-40.

PMID:3601131
Abstract

Among unusual echinococcus cysts, muscular hydatidosis merits particular attention. Careful analysis of the statistics provided by the literature shows that the condition is not all that rare: its incidence varies from 0.5 to 4.7%, making it less common than hepatic or pulmonary cysts but more frequent than cysts of the kidneys, bone, pancreas, spleen or mesenterium. There are disagreements about the percentage distribution in the various muscular districts but it seems that the incidence gradually decreases as we go from the muscles of the torso and the root of the limbs to the distal extremities. The Palermo University case series includes 6 cases of which 5 muscular and one in the connective tissue. Of the 4 muscular cases, only one is to be considered secondary. For the purposes of correct preoperative diagnosis we should not neglect either anamnestic data or laboratory tests. Though the latter are not specific they are helpful for differential diagnosis from other muscular neoformation. Exploratory centesis that must be performed very cautiously in order to prevent dissemination appears to be more specific. Radiography and ultrasound examinations permit the direct study of cystic formations and a general assessment of the possibility of multiple hydatid locations. The only possible treatment is surgical. Though total removal of the cyst is the operation of choice, this is not always possible if the cyst is very big and adhering to other structures. In this case the procedure to be adopted is sterilisation and aspiration of the content, removal of the membrane and treatment of the pericystium.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在不常见的棘球蚴囊肿中,肌肉包虫病值得特别关注。仔细分析文献提供的统计数据表明,这种情况并非那么罕见:其发病率在0.5%至4.7%之间,比肝囊肿或肺囊肿少见,但比肾、骨、胰腺、脾或肠系膜囊肿更常见。对于各肌肉区域的百分比分布存在分歧,但似乎从躯干和肢体根部的肌肉到远端肢体,发病率逐渐降低。巴勒莫大学的病例系列包括6例,其中5例为肌肉型,1例为结缔组织型。在4例肌肉型病例中,只有1例被认为是继发性的。为了进行正确的术前诊断,我们不应忽视病史资料或实验室检查。尽管后者不具有特异性,但有助于与其他肌肉新生物进行鉴别诊断。为防止播散必须非常谨慎进行的诊断性穿刺似乎更具特异性。X线摄影和超声检查可直接研究囊性结构,并对多发包虫病的可能性进行总体评估。唯一可能的治疗方法是手术。尽管完全切除囊肿是首选手术,但如果囊肿非常大且与其他结构粘连,这并不总是可行的。在这种情况下,应采取的手术是对内容物进行消毒和抽吸、切除囊膜并处理包囊周围组织。(摘要截取自250词)

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