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目的 进一步研究和评价囊型包虫病药物治疗的疗效判定标准。 方法 采用前瞻性随机对照观察的研究方法。对 4 9例肝囊型包虫病病人进行了研究 ,其中治疗组 31例为经过不同时间阿苯达唑乳剂治疗的病人。对照组 18例为未经任何治疗的病人。以外科手术、粗针穿刺抽吸和常规细针穿刺的方法采集包虫囊内容物观察其性状。囊壁组织石腊切片观察组织学变化。收集原头节通过镜下形态及活动的观察、染料排斥试验、犬胆汁激活试验及接种小鼠腹腔 6个月后剖检观察有无包虫囊生长的方法判定囊内原头节的死活。结合 CT及 B超影像特征进行比较评价。 结果 治疗组病人中87.1% (2 1/ 31)的包虫囊 B超影像显示不同程度的退行变性 ,育囊率为 2 2 .6 %。对照组病人包虫囊的 B超影像显示退行变性的占 11.1% (2 / 18) ,育囊率为 6 1.1%。治疗组判定为痊愈的 15例病人的育囊率为 13.3% (2 / 15 )。疗效标准与 B超影像反映的包虫囊变性死亡的过程一致 ,与寄生虫学和囊壁组织学变化趋势相符。177例停药后随访 1～ 4年的肝囊型包虫病病人的转归证明了这一标准的可靠性。 结论 本研究提出的以 B超影像为基础的肝囊型包虫病药物治疗疗效指标反映了包虫囊在药物作用下从正常生长到变性死亡的过程 ,是一个比较客观、合理的疗效标
Objective To further study and evaluate the efficacy of cystic echinococcosis drug treatment criteria. Methods A prospective randomized controlled study was used. Forty-nine patients with cystic echinococcosis were studied, of which 31 were treated with albendazole emulsion at different times. Control group of 18 patients without any treatment. Surgical operation, crude needle aspiration and routine fine needle aspiration were used to collect the contents of hydatid cysts to observe their traits. The histopathological changes of paraffin section of the cyst wall were observed. Collected the original head section through the microscopic observation of the morphology and activity, dye exclusion test, canine bile activation test and inoculated mice abdominal cavity 6 months after necropsy to observe the presence or absence of hydatid disease growth to determine the original capsule in the life and death. Combined with CT and B ultrasound imaging characteristics were compared and evaluated. Results 87.1% (21/31) of the hydatid cysts in the treatment group showed degenerative degenerative changes in varying degrees with the rate of 22.6%. In the control group, the B ultrasound image of hydatid disease showed that degeneration and degeneration accounted for 11.1% (2/18) and the cyst rate was 61.1%. The cure rate of 15 cases in the treatment group was 13.3% (2/15). Efficacy standards and B ultrasound images of hydatid degeneration consistent with the process of death, and parasitology and histopathological changes consistent. The outcome of 177 patients with hepatocystic hydatid disease who were followed up for 1 to 4 years after discontinuation demonstrated the reliability of this standard. Conclusion The efficacy index of drug treatment of hepatic cystic echinococcosis based on B-mode ultrasound presented in this study reflects the process of hydatid cyst from normal growth to degeneration and death under the influence of drugs. It is an objective and reasonable therapeutic index