1 Materials and methods
Since 1980, we have examined 175 cases of hydatidectomy specimens, including 98 males and 77 females. Specimens sent for inspection were fixed with 10% formalin solution, routinely collected, paraffin sections, and HE stained. A special liver alveolar hydatid specimen was diagnosed by PAS and mesh fiber staining.
2 results
2.1 Age distribution The age of onset is 3 to 65 years, with an average of 31.60 years. Men are 3 to 65 years old, with an average of 31.92 years old, and women are 4 to 62 years old, with an average of 31.85 years old. The age group with high incidence of hydatidosis is 20-29 years old, accounting for 26.86%, followed by 30-39 years old, accounting for 18.86%.
2.2 The site of occurrence is liver accounted for 57.14% (100 cases), lung accounted for 18.86% (33 cases), intestine and mesentery accounted for 7.43% (13 cases), soft tissue accounted for 4.57% (8 cases), brain accounted for 1.14% (2 cases ), One case each of gallbladder, spleen, kidney, bile duct, and mediastinum, and the occurrence of multiple organs (including liver and intestine, etc.) accounted for 8.0% (14 cases).
2.3 Pathological characteristics The majority of Echinococcus granulosus is mostly white cystic structure, and the cysts are mostly unicellular. The cyst wall is about 1 mm thick. The cyst contains colorless or light yellow liquid. When some are accompanied by infection, cheese-like substance or calcification can be seen in the capsule. Hepatic alveolar echinococcosis is generally observed as massive or nodular, gray or light yellow, hard, with a gravel-like feeling when cutting, rarely bleeding, and occasionally spotted patterns on the cut surface, necrotic pale yellow areas and The gray and shiny fibers alternate, with interspersed or piled small vesicles. There is no fibrous capsule on the periphery of the mass, and the boundary with the surrounding tissue is unclear. Mirror: Echinococcus granulosus only sees red-stained parallel slab structure. Hepatic alveolar echinococcosis is seen by many small vesicles
The wall is a pink-stained stratum corneum-like structure with scattered calcified areas and a lot of necrosis. The outline of degeneration vesicles can be seen inside. There is no obvious boundary between the diseased area and normal liver tissue, and it shows invasive growth.
In this group of cases, 8 cases of alveolar echinococcosis had a history of close contact with animals such as sheep, dogs, and cattle. The longest course of disease is 6 years and the shortest is 1 year. Preoperative diagnosis of tumor in 3 cases, radical hemihepatectomy in 4 cases, palliative lesion resection or major lesion resection in 3 cases, only one biopsy in a wide range of lesions.
3 Discussion
This area is the main residential area of ​​the Uyghur people. Most of the patients are farmers and herdsmen. According to the living habits of local ethnic minorities, the transmission of infection may be: (1) History of close contact with animals such as sheep, dogs, and cattle. (2) Ethnic minorities eat a diet called "pilaf" and replace tableware with their hands. Increase the chance of infection. (3) Locally used to eat half-cooked mutton (commonly known as kebab). (4) Pollution of drinking water sources. Local waterlogging dam water or canal water is the main water source, of which waterlogging dam water is the main source. The waterlogging dam water is a source of long-term accumulation of water from the river to the pit. It has not been replaced for many years, and some waterlogging dam water is shared by people and animals, causing serious pollution.
Clinically, alveolar echinococcosis is very rare, the course of disease is generally longer, and some cases are more difficult to diagnose before surgery. Among the 8 cases of alveolar echinococcosis in this group, 5 had unique bumps in the liver area, such as cartilage-like solid hard masses, which were easily confused with liver cancer. Because the symptoms of hepatic alveolar echinococcosis are mild and the disease course is long, the lesions are usually huge during surgical resection, most of which involve the left and right liver lobes. In some cases, only palliative surgery or biopsy can be performed. One of the cases in this group failed to cure because of the huge lesion only biopsy. The above factors may be related to poor medical conditions, economic backwardness, and inconvenient transportation in the region. The patient's condition often develops to a serious degree when he sees a doctor, which undoubtedly affects the treatment and prognosis of the patient. Therefore, the key to the treatment of this disease is early detection, early diagnosis and early treatment.
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