CAJ | 학술논문

通过现有病例结合相关文献分析曼氏裂头蚴在供肾的寄生特征.49岁女性自愿捐献一肾脏给儿子,健康评估结果符合活体捐献肾脏标准.供肾切取后,修肾时发现供肾腹侧面脂肪囊内近肾门处有一长条形囊肿,切开囊肿,从中抽出一条乳白色活动的带状虫体,经鉴定为曼氏迭宫绦虫裂头蚴(活体).囊肿病理检查为肉芽肿性炎症,并中性粒细胞及嗜酸粒细胞浸润.术后供、受者均服用吡喹酮治疗,3个月内多次粪检均未见节片和虫卵排出,也无任何不适症状.供者感染的方式和途径可能是食用未熟的转续宿主肉类或误食受感染的剑水蚤.肾移植前供、受者应进行曼氏裂头蚴等寄生虫感染的检查.由于寄生于肾脏的裂头蚴由于无明显症状,很少被发现,从粪便中查到本虫虫卵为诊断曼氏迭宫绦虫病的依据,询问病史有一定参考价值,血中嗜酸粒细胞增多常提示慢性寄生虫感染,必要时还可以进行动物感染实验,还可以用裂头蚴抗原进行各种免疫学试验可为该病提供免疫学辅助诊断依据.确诊主要靠手术或病理组织检查取得虫体即可确诊并治疗.综合采用CT检查和MRI检查等放射影像技术对供肾裂头蚴病有一定的鉴别诊断价值.
통과현유병례결합상관문헌분석만씨렬두유재공신적기생특정.49세녀성자원연헌일신장급인자,건강평고결과부합활체연헌신장표준.공신절취후,수신시발현공신복측면지방낭내근신문처유일장조형낭종,절개낭종,종중추출일조유백색활동적대상충체,경감정위만씨질궁조충렬두유(활체).낭종병리검사위육아종성염증,병중성립세포급기산립세포침윤.술후공、수자균복용필규동치료,3개월내다차분검균미견절편화충란배출,야무임하불괄증상.공자감염적방식화도경가능시식용미숙적전속숙주육류혹오식수감염적검수조.신이식전공、수자응진행만씨렬두유등기생충감염적검사.유우기생우신장적렬두유유우무명현증상,흔소피발현,종분편중사도본충충란위진단만씨질궁조충병적의거,순문병사유일정삼고개치,혈중기산립세포증다상제시만성기생충감염,필요시환가이진행동물감염실험,환가이용렬두유항원진행각충면역학시험가위해병제공면역학보조진단의거.학진주요고수술혹병리조직검사취득충체즉가학진병치료.종합채용CT검사화MRI검사등방사영상기술대공신렬두유병유일정적감별진단개치.
Parasitism characteristics of spirometra mansoni sparganum in the living donor kidney are analyzed by present cases and relevant literatures. A female aged 49 years voluntarily donated a kidney to her son. Results of healthy evaluation were accorded with the standards of living donor kidney. During repairing kidney, a sliver cyst was found in the adipose capsule on the kidney ventral surface, near to the renal hilum. The cyst was incised, and a ivory white girdle-shaped worm was obtained. After identification, the worm was identified spirometra mansoni sparganum (living body). Pathological examination showed that the cyst developed granulomatous inflammation, combined with neutrophil and eosinophilic granuiocyte infitration. Following surgery, the donor and recipient were treated with praziquantel. No proglottid or worm ovum was detected by dung detection within 3 months, without any discomfortable symptom. The infection mode and pathway may be by eating unmatured paratenic host meat or infected cyclops. The donor and recipient should be examined for parasitic infection of sparganosis mansoni prior to transplantation. No significant symptom could be detected following parasitism of sparganosis mansoni in the kidney, so it was seldom found. Worm ovum was examined in feces, which could be the evidence for sparganosis mansoni and for case history inquisition. Eosinophilia in the blood always indicated that chronic parasitic infection. Zoogenetic infection test could be tested when necessary. Sparganum antigen could be used for various immunological tests, which could provide evidence for auxiliary diagnosis of immunology. The diagnosis was usually confirmed by obtaining a polypide by surgery or histological examination. CT scanning and magnetic resonance imaging have diagnostic value of renal sparganosis mansoni.