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1、Hepatic HydatidosisNew wordsNew words Hepatic hydatidosis 肝包虫病肝包虫病 hiptik ,haidtidusis echinococcosis i,kainkksis 包虫病包虫病parasitic disease,prsitik 寄生虫病寄生虫病cyst sist 包囊、孢囊、囊肿包囊、孢囊、囊肿larval l:vl 幼虫的；幼虫状态的幼虫的；幼虫状态的tapeworm teipw:m 绦虫绦虫alveolar lvil 肺泡的；齿槽的肺泡的；齿槽的Infectious agent 传染源传染源Echinococcus granu
2、losus ,grnjulusis 细粒棘球绦虫细粒棘球绦虫brood capsule 育囊育囊protoscoleces 原头节原头节(动动)leakage li:kid 泄漏；渗漏物泄漏；渗漏物rupture 破裂破裂Incubation period 潜伏期潜伏期Reservoir rezvw:宿主宿主canid knid 犬科动物犬科动物feline fi:lain 猫科动物猫科动物carnivores ka:niv:z 食肉动物食肉动物herbivores h:biv:z 食草动物食草动物definitive host difinitiv 终宿主终宿主Intermediate hos
3、t 中间宿主中间宿主pasture p:st 草地、牧场、牧草草地、牧场、牧草offal fl 内脏、垃圾内脏、垃圾serological tests siruldikl 血清学试验血清学试验 fluorescent antibody 荧光抗体荧光抗体indirect haemagglutination antibody testing.血细胞凝集抗体检测血细胞凝集抗体检测New wordsNew wordsalbendazole 阿苯达唑阿苯达唑percutaneous drainage,p:kju:teinis经皮穿刺引流术经皮穿刺引流术praziquantel,preizkwntl 吡喹
4、酮吡喹酮Liver hydatid internal capsule enucleation 肝包虫内囊摘除术肝包虫内囊摘除术 haidtid i,nju:klieinThe capsule was stripped of liver hydatid 肝包虫外囊剥离术肝包虫外囊剥离术 Liver resection 肝叶切除术肝叶切除术hepatic cystic echinococcosis(HCE)肝囊性包虫病肝囊性包虫病hepatic alveolar echinococcosis(HAE)肝泡型包虫病肝泡型包虫病nHepatic hydatidosis(echinococcosis o
5、f liver)It is a kind of parasitic disease which produced by cysts that are the larval stages of the tapeworm echinococcus parasitize the liver.Definitionhepatic cystic echinococcosis(HCE)97%1hepatic alveolar echinococcosis(HAE)3%2Classification囊性包虫病囊性包虫病CE 泡型包泡型包 虫病虫病AEChina（CE and AE）Ding，1991Echin
6、ococcosis popular distributionThe global echinococcosis distribution schemes Echinococcosis popular distributionnEchinococcus granulosus(dog tapeworm)is the causative agent.Infectious agentnHydatid disease in humans is produced by cysts that are the larval stages of the tapeworm Echinococcus.Brood c
7、apsules are formed within cysts,cysts containing 3040 protoscoleces.Each of these is capable of developing into a single tapeworm.Symptoms depend on the location of the cyst within the body and develop as a result of pressure,leakage or rupture.The most common site for the cysts is the liver.Less co
8、mmonly brain,lungs and kidneys are affected.The heart,thyroid and bone are uncommonly affected.IdentificationClinical features ECAEnThe incubation period varies from months to years.Incubation periodnThe domestic dog and other canids,definitive hosts for echinococcus granulosus,may harbour thousands
9、 of adult tapeworms without being symptomatic.nFelines and most other carnivores are normally not suitable hosts for the parasite.ReservoirnIntermediate hosts include herbivores,sheep,cattle,goats,pigs,horses,kangaroos and camels.Sheep are the major intermediate hosts.Sheep eat the worm eggs from pa
10、sture contaminated with dog faeces.These hatch inside the sheep,forming cysts.The life cycle is completed when dogs are infected through eating the offal of infected livestock or wild animals,particularly the liver and lung.ReservoirnHuman infection occurs by hand-to-mouth transfer of tapeworm eggs
11、from dog faeces.The larvae penetrate the intestinal mucosa,enter the portal system and are carried to various organs where they produce cysts in which infectious protoscoleces develop.Mode of transmissionnThe important life cycle is dog-sheep-dog.A dingo-wallaby-dingo(or wild dog)sylvatic cycle also
12、 occurs.A dog-wild pig-dog cycle has been recognised and poses a special risk for wild pig-hunters.Mode of transmission图图.囊型包虫病囊型包虫病人人泡型包虫病循环图泡型包虫病循环图 nYoung children are more likely to be infected as they are more likely to have closer contact with infected dogs and they are less likely to have app
13、ropriate hygiene habits.There is no evidence to suggest children are more susceptible to infection than adults.Susceptibility&resistancenDiagnosis may be made by X-ray,ultrasound or CT scan.If a cyst ruptures,appropriate examination for protoscoleces,brood capsules and cyst wall in sputum,vomitus,fa
14、eces or urine should be undertaken.nThe Casoni skin test has now been replaced by serological tests for hydatid disease.These include fluorescent antibody(FA)and indirect haemagglutination antibody testing.Method of diagnosisCommon complications1Cyst secondary infection2 Cyst burstTreatment Surgery
15、is often the treatment of choice for infection with echinococcus granulosus,sometimes combined with prolonged high-doses of the drug albendazole.nPercutaneous drainage with ultrasound guidance plus prolonged high-dose albendazole therapy has been effective for liver cysts.nPraziquantel followed by p
16、rolonged high-dose albendazole therap is used if there is cyst spillage from trauma or surgery.Consult the current version of Therapeutic guidelines:antibiotic(Therapeutic Guidelines Limited).Specialist infectious disease advice should be sought.TreatmentSurgical treatment1Liver hydatid internal capsule enucleation Surgical treatment2.The capsule was stripped of liver hydatidSurgical treatment3.Liver resection
