ObjectiveTo investigate and analysis the data of patients with hepatic echinococcosis in Ganzi County in 2018, and to understand the epidemiological characteristics of hepatic echinococcosis in Ganzi County, Sichuan Province.MethodsA total of 811 patients were enrolled. The basic information of sex, age, weight, occupation, nation, educational level, family address and so on were recorded. The location, number, classification, transverse diameter and longitudinal diameter of hepatic echinococcosis masses were recorded by abdominal color Doppler ultrasonography.ResultsIn 2018, 811 new cases of hepatic echinococcosis were reported in Ganzi County, with a prevalence rate of 4.6% (811/17 650), and 17.81% (572/3 212) in the Datongma area. Patients ranged in age from 6 to 92, the average age was (44.8±16.6) years old. The majority of patients were Tibetans (98.5%), herdsmen (71.8%) and illiterates (83.5%). The most common lesions were in right liver (84.2%) and single (91.4%).ConclusionsThere is serious transmission of hepatic echinococcosis in Ganzi County, especially in pure pastoral areas, and HAE is more prevalent than HCE. Most of the infected people are Tibetan herdsmen with illiterate educational background and more females than males. The peak incidence of hepatic echinococcosis is 30-55 years old. Close monitoring should be carried out for these people.
ObjectiveTo summarize the therapeutic effect and clinical significance of reduced volume lesion resection combined with drug therapy for end-stage alveolar hepatic echinococcosis.MethodClinical data of 46 patients with end-stage alveolar hepatic echinococcosis who received treatment of reduced volume lesion resection combined with drug therapy at Department of General Surgery of Qinghai Provincial People’s Hospital from March 2013 to October 2019 were retrospectively analyzed.ResultsAmong the 46 patients, 3 patients were lost to follow-up and 43 patients received follow-up. The follow-up time ranged from 3 to 79 months, with the median of 40 months. Fifteen patients died during the follow-up period, of which 5 patients with cerebral hydatid disease died during 16–36 months due to acute seizures and cerebral edema, 4 patients with multiple systemic metastases died during 9–36 months due to multiple organ failure, 2 patients with pulmonary echinococcosis died due to acute pulmonary embolism, 4 patients died in 2 years after operation due to recurrent biliary tract infection, other patients survived during follow-up period without distant organ metastasis.ConclusionReduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis can improve the patient’s quality of life, reduce the hospital cost, reduce the occurrence of postoperative complications, and shorten the length of hospital stay.
ObjectiveTo comprehend the current diagnosis status and new progress of hepatic echinococcosis (HE). MethodThe literature from domestic and foreign researchers relevant diagnosis of HE in recent years was searched and summarized. ResultsThe HE was widely distributed worldwide, with extremely high mortality and disability rates, posing a serious threat to local economic development and public health. At present, in addition to the traditional and widely recognized diagnostic methods based on epidemiological histories, clinical manifestations, routine imaging, and experimental examinations, many innovative technologies based on these traditional diagnostic methods had emerged in the field of HE, such as diagnostic prediction models constructed based on ultrasound and other imaging data, artificial intelligence, three-dimensional visual reconstruction, and circulating free DNA testing, which significantly improved the diagnosis rate of the HE. ConclusionsIn recent years, with the continuous improvement of medical level, the in-depth and perfect exploration of HE has made remarkable progress, which not only provides a new possibility for the early diagnosis of the HE, but also provides an important basis for research in related fields and the formulation of prevention and control measures. Therefore, the further promotion and application of these new techniques will aid to improve the diagnosis status of HE and reduce its impact on population health.
This review comprehensively outlined the application of imaging, immunology, and molecular biology techniques in the detection of hepatic echinococcosis. Imaging techniques, represented by ultrasound, computed tomography , magnetic resonance imaging, and positron emission tomography, not only provided critical information about the morphology, location, and characteristics of hepatic echinococcosis lesions, but could also be combined with artificial intelligence technologies to enhance diagnostic capabilities and expand the application scenarios of imaging technologies. These techniques were essential tools for the diagnosis, screening, and prevention of hepatic echinococcosis. Immunological techniques, such as indirect hemagglutination assay, enzyme-linked immunosorbent assay, immunoblotting, and chemiluminescence immunoassay, aided in diagnosis and differential diagnosis by detecting specific antibodies. Molecular biology techniques, such as polymerase chain reaction and high-throughput sequencing, provided robust support for the diagnosis and pathogen identification of hepatic echinococcosis due to their high sensitivity and specificity. Based on these three major technologies, more sensitive, specific, convenient, and cost-effective detection techniques had emerged, offering more options for the detection and control of hepatic echinococcosis. Additionally, constructing comprehensive diagnostic models by combining the advantages of different detection technologies will help improve the diagnostic efficiency of hepatic echinococcosis.
We reviewed the research progress of anesthesia in hepatic echinococcosis surgery in recent years, including the key technologies, practical experience, and research progress of anesthesia in hepatic echinococcosis surgery, so as to guide clinical practice. Firstly, in the selection of anesthesia, general anesthesia combined with epidural block or regional nerve block was recommended to improve surgical safety and patient comfort. At the same time, the importance of intraoperative continuous monitoring, including key indicators such as hemodynamics and respiratory function, was emphasized, and transesophageal echocardiography and brain function monitoring techniques were introduced to optimize anesthesia management. Finally, the concept of enhancend recovery after surgery was promoted, and measures such as preoperative optimization, intraoperative heat preservation, refined fluid management, and postoperative analgesic management were implemented to promote the rapid recovery of patients. At the same time, some challenges and unsolved problems in the current research also were pointed out, such as complex case evaluation, complication prevention, and teamwork, etc., which need to be further studied in the future to optimize the anesthesia strategy.