中国寄生虫学与寄生虫病杂志 ›› 2021, Vol. 39 ›› Issue (1): 61-68.doi: 10.12140/j.issn.1000-7423.2021.01.009

• 论著 • 上一篇    下一篇

棘球蚴病住院患者临床特征分析

朱凌虹1(), 祝路民2,*(), 王勃1, 杨智勇1, 张静妮1, 吉莉1, 蔡其刚1, 韩秀敏1   

  1. 1 青海省人民医院科教处,西宁 810007
    2 山东威海第970医院,威海 264200
  • 收稿日期:2020-05-22 修回日期:2020-08-13 出版日期:2021-02-28 发布日期:2021-03-10
  • 通讯作者: 祝路民
  • 作者简介:朱凌虹(1981-),女,硕士,主治医师,从事全科医学棘球蚴病临床研究。E-mail: 33286413@qq.com
  • 基金资助:
    青海省卫计委2016年卫生计生指导性课题(2016-wjzdx-11)

Analysis of clinical features of echinococcosis cases

ZHU Ling-hong1(), ZHU Lu-min2,*(), WANG Bo1, YANG Zhi-yong1, ZHANG Jing-ni1, JI Li1, CAI Qi-gang1, HAN Xiu-min1   

  1. 1 Department of Science and Education, Qinghai Provincial People’s Hospital, Xining 810007, China
    2 Weihai No. 970 Hospital, Weihai 264200, China
  • Received:2020-05-22 Revised:2020-08-13 Online:2021-02-28 Published:2021-03-10
  • Contact: ZHU Lu-min
  • Supported by:
    2016 Health and Family Planning Guiding Subject of Qinghai Provincial Health and Family Planning Commission(2016-wjzdx-11)

摘要:

目的 分析青海省棘球蚴病住院患者的临床资料和治疗情况,为提高棘球蚴病的综合诊治效果提供科学依据。 方法 以青海省人民医院2016年1月—2019年6月收治的949例棘球蚴病住院患者临床资料为研究对象,收集患者的人口学信息及临床信息,采用EpiData 3.02软件进行数据双录入,以棘球蚴病是否治愈为因变量,对两型棘球蚴病的疾病转归进行单因素分析,并根据单因素分析结果,构建Logistic回归模型,分析影响棘球蚴病患者治愈的影响因素,应用SPSS 17.0统计学软件对数据进行统计分析。 结果 共整理了949例棘球蚴病患者临床资料,细粒棘球蚴病(cystic echinococcosis,CE)756例,其中男性350例,女性406例;多房棘球蚴病(alveolar echinococcosis,AE)193例,其中男性90例,女性103例,女性较男性略多;藏族CE 524例、AE 141例;职业以农牧民为主,CE 604例、AE 157例;文化程度均以文盲为主,CE 596例、AE 147例;CE以青海省玉树州多见(209例),AE以青海省果洛州多见(93例)。临床症状腹部不适CE 579例,AE 140例;肝功能Child-Pugh分级A级CE 663例,AE 142例;超声声像学分型CE2(多子囊型)227例、CE4(实变型)302例、AE1(浸润型)162例;手术治疗CE 409例,AE 83例。CE疾病转归的单因素分析结果显示,不同性别、年龄段、包囊大小、超声声像学分型、有无并发症、是否手术组间转归不同(P < 0.01);AE疾病转归的单因素分析结果显示,肝功能分级(P < 0.05)、是否手术(P < 0.01)组间转归不同。Logistic回归结果显示,影响CE患者治愈的主要因素为性别(P < 0.05)、包囊大小(P < 0.05)和是否手术(P < 0.01),而影响AE患者治愈的主要因素仅为手术治疗(P < 0.01)。 结论 青海省两型棘球蚴病住院患者的临床资料分析结果显示,手术是提高两型棘球蚴病治愈率的主要治疗方式。

关键词: 棘球蚴病, 住院病例, 临床特征, 治疗情况, 疾病转归

Abstract:

Objective To analyze the clinical features and treatment of echinococcosis inpatients in Qinghai Province, in order to provide scientific basis for improvement of diagnosis and treatment of echinococcosis. Methods Demographic and clinical information of 949 echinococcosis inpatients in Qinghai Provincial People’s Hospital during January 2016 and June 2019 were collected and entered in database in duplicates by using the EpiData software 3.02. Univariate analysis was performed for the two types of echinococcosis, using hydatid disease as the dependent variable. Logistic regression model was constructed based on the univariate analysis results, in order to analyze factors influencing the treatment outcome of echinococcosis. Data were analyzed with the SPSS 17.0 software. Results Clinical information of 949 echinococcosis cases was collected, including 756 cystic echinococcosis (CE) cases comprising 350 males and 406 females, and 193 alveolar echinococcosis (AE) cases comprising 90 males and 103 females. There were 524 Tibetan CE cases and 141 Tibetan AE cases. The cases were mainly distributed in farmers and herdsmen, including 604 CE cases and 157 AE cases. Most of the cases were illiterate, including 596 CE cases and 147 AE cases. CE cases were mainly distributed in Yushu Prefecture (209 cases) and AE mainly in Guoluo Prefecture (93 cases). In addition, 548 CE cases and 141 AE cases had clinical symptoms of abdominal discomfort, while 663 CE cases and 142 AE cases had Child-Pugh stage A of liver functions. Ultrasound imaging classification revealed 227 cases of the CE2 type and 302 cases of the CE4 type, and the predominance of AE1 type among the AE cases. Moreover, 19.8% CE cases and 19.2% AE cases had complications; 409 CE cases and 83 AE cases received surgery. The univariate analysis of CE showed that gender, age, cyst size, ultrasonic image classification, the occurrence of complications and prognosis of surgery (P < 0.01) were different between groups. The univariate analysis of AE showed that the Child-Pugh score (P < 0.05) and prognosis of surgery (P < 0.01) were different between groups. Logistic regression results showed that the main factors influencing the cure of CE were gender (P < 0.05), cyst size (P < 0.05) and whether or not receiving surgery (P < 0.01), while surgery (P < 0.01) was the main factor influencing the cure of AE. Conclusion The clinical data of the two types of echinococosis in Qinghai Province suggest that surgery is an effective way to improve the cure rate of AE and CE.

Key words: Echinococcosis, Hospitalization cases, Clinical features, Treatment condition, Prognosis of disease

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