[Evaluation of surgical efficacy in patients with hepatic cystic echinococcosis in Gansu Province from 2006 to 2023].

Q3 Medicine
X Cheng, Y Feng, X Wang, Z Wang, J Lei, M Jiang, G Yang, X Zhang, S Yang, L Wang
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Hepatic cystic echinococcosis patients with complete medical records and follow-up data were included in the study, and patients' characteristics, including hospital where patients received diagnosis and treatment, methods of case identification, year of surgery, classification of lesions, number of lesions, size of lesions, course of disease, surgical methods, and post-surgical follow-up data. The cure and recurrence of hepatic cystic echinococcosis were evaluated according to the <i>Guidelines for Management of Echinococcosis Patients in the Central Government Fiscal Transfer Payment Program</i>, and the cure and recurrent rates were calculated.</p><p><strong>Results: </strong>Data were collected from 1 686 surgical patients with hepatic cystic echinococcosis. According to the inclusion and exclusion criteria, 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments were included during the period from 2006 to 2022, including 1 166 cured patients (95.42%) and 88 patients with postsurgical recurrence (7.20%), and the cure rate of surgical treatments appeared a tendency towards a rise among patients with hepatic cystic echinococcosis from 2008 to 2022 (χ<sup>2</sup><sub>trend</sub> = 19.39, <i>P</i> < 0.05). The cure rates of hepatic cystic echinococcosis were 100% (177/177), 94.81% (128/135) and 94.62% (861/910) among patients detected through regular physical examinations, screened by the central government fiscal transfer payment program for echinococcosis control, and those who passively sought healthcare services, respectively (χ<sup>2</sup> = 9.95, <i>P</i> < 0.05). The cure rates of hepatic cystic echinococcosis were 95.96% (1 046/1 090) among patients with a disease course of 2 years and less and 90.90% (120/132) among patients with a disease course of over 2 years (χ<sup>2</sup> = 6.87, <i>P</i> < 0.05), and there were significant differences in the cure rates among patients with hepatic cystic echinococcosis in terms of number of lesions (χ<sup>2</sup> = 24.44, <i>P</i> < 0.05) and surgical methods (<i>P</i> < 0.05). The cure rate of hepatic cystic echinococcosis patients was significantly higher following initiation of the central government fiscal transfer payment program for echinococcosis control (96.06%, 1 096/1 141) than before the program (86.42%, 70/81) (χ<sup>2</sup> = 16.06, <i>P</i> < 0.05), and the cure rate of hepatic cystic echinococcosis patients was significantly higher in designated hospitals (96.48%, 741/768) than in non-designated hospitals (93.37%, 366/392) (χ<sup>2</sup> = 5.78, <i>P</i> < 0.05). The median follow-up period was 4 (interquartile range, 7) years among 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments. The recurrent rate of hepatic cystic echinococcosis appeared a tendency towards a decline from 2008 to 2022 (χ<sup>2</sup><sub>trend</sub> = 36.86, <i>P</i> < 0.05), with a reduction from 23.08% (9/39) in 2008 to 1.85% (1/54) in 2021, and the post-surgical recurrence rate of hepatic cystic echinococcosis was lower following initiation of the central government fiscal transfer payment program for echinococcosis control (5.87%, 67 / 1 141) than before the program (25.93%, 21/81) (χ<sup>2</sup> = 45.51, <i>P</i> < 0.05). In addition, the post-surgical recurrence rate of hepatic cystic echinococcosis was higher in non-designated hospitals (10.46%, 41/392) than in designated hospitals (5.60%, 43/768) (χ<sup>2</sup> = 9.12, <i>P</i> < 0.05), and there was a significant difference in the post-surgical recurrence rate among patients with hepatic cystic echinococcosis in terms of surgical methods (<i>P</i> < 0.05), with the highest recurrence rate (11.54%) seen among patients undergoing percutaneous fine-needle aspiration of cyst fluids-based surgical procedures (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Since the initiation of the central government fiscal transfer payment program for echinococcosis control in Gansu Province in 2006, an increase in the surgical cure rate and a reduction in the recurrence of hepatic cystic echinococcosis had been found among patients with hepatic cystic echinococcosis, indicating a high overall therapeutic efficacy.</p>","PeriodicalId":38874,"journal":{"name":"中国血吸虫病防治杂志","volume":"37 3","pages":"247-254"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国血吸虫病防治杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.16250/j.32.1915.2025016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To evaluate the therapeutic efficacy for surgical treatments among patients with hepatic cystic echinococcosis in Gansu Province from 2006 to 2023, so as to provide insights into optimization of the diagnosis and treatment strategies against hepatic cystic echinococcosis.

Methods: The demographic and clinical data of all echinococcosis cases included in central government fiscal transfer payment program for echinococcosis control and undergoing surgical treatments in Gansu Province from 2006 to 2023 were captured. Hepatic cystic echinococcosis patients with complete medical records and follow-up data were included in the study, and patients' characteristics, including hospital where patients received diagnosis and treatment, methods of case identification, year of surgery, classification of lesions, number of lesions, size of lesions, course of disease, surgical methods, and post-surgical follow-up data. The cure and recurrence of hepatic cystic echinococcosis were evaluated according to the Guidelines for Management of Echinococcosis Patients in the Central Government Fiscal Transfer Payment Program, and the cure and recurrent rates were calculated.

Results: Data were collected from 1 686 surgical patients with hepatic cystic echinococcosis. According to the inclusion and exclusion criteria, 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments were included during the period from 2006 to 2022, including 1 166 cured patients (95.42%) and 88 patients with postsurgical recurrence (7.20%), and the cure rate of surgical treatments appeared a tendency towards a rise among patients with hepatic cystic echinococcosis from 2008 to 2022 (χ2trend = 19.39, P < 0.05). The cure rates of hepatic cystic echinococcosis were 100% (177/177), 94.81% (128/135) and 94.62% (861/910) among patients detected through regular physical examinations, screened by the central government fiscal transfer payment program for echinococcosis control, and those who passively sought healthcare services, respectively (χ2 = 9.95, P < 0.05). The cure rates of hepatic cystic echinococcosis were 95.96% (1 046/1 090) among patients with a disease course of 2 years and less and 90.90% (120/132) among patients with a disease course of over 2 years (χ2 = 6.87, P < 0.05), and there were significant differences in the cure rates among patients with hepatic cystic echinococcosis in terms of number of lesions (χ2 = 24.44, P < 0.05) and surgical methods (P < 0.05). The cure rate of hepatic cystic echinococcosis patients was significantly higher following initiation of the central government fiscal transfer payment program for echinococcosis control (96.06%, 1 096/1 141) than before the program (86.42%, 70/81) (χ2 = 16.06, P < 0.05), and the cure rate of hepatic cystic echinococcosis patients was significantly higher in designated hospitals (96.48%, 741/768) than in non-designated hospitals (93.37%, 366/392) (χ2 = 5.78, P < 0.05). The median follow-up period was 4 (interquartile range, 7) years among 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments. The recurrent rate of hepatic cystic echinococcosis appeared a tendency towards a decline from 2008 to 2022 (χ2trend = 36.86, P < 0.05), with a reduction from 23.08% (9/39) in 2008 to 1.85% (1/54) in 2021, and the post-surgical recurrence rate of hepatic cystic echinococcosis was lower following initiation of the central government fiscal transfer payment program for echinococcosis control (5.87%, 67 / 1 141) than before the program (25.93%, 21/81) (χ2 = 45.51, P < 0.05). In addition, the post-surgical recurrence rate of hepatic cystic echinococcosis was higher in non-designated hospitals (10.46%, 41/392) than in designated hospitals (5.60%, 43/768) (χ2 = 9.12, P < 0.05), and there was a significant difference in the post-surgical recurrence rate among patients with hepatic cystic echinococcosis in terms of surgical methods (P < 0.05), with the highest recurrence rate (11.54%) seen among patients undergoing percutaneous fine-needle aspiration of cyst fluids-based surgical procedures (P < 0.05).

Conclusions: Since the initiation of the central government fiscal transfer payment program for echinococcosis control in Gansu Province in 2006, an increase in the surgical cure rate and a reduction in the recurrence of hepatic cystic echinococcosis had been found among patients with hepatic cystic echinococcosis, indicating a high overall therapeutic efficacy.

[2006 - 2023年甘肃省肝囊性包虫病手术疗效评价]。
目的:评价2006 - 2023年甘肃省肝囊性包虫病手术治疗的疗效,为优化肝囊性包虫病的诊治策略提供参考。方法:收集2006 - 2023年甘肃省所有纳入中央财政棘球蚴病控制转移支付计划并接受手术治疗的棘球蚴病患者的人口学和临床资料。纳入有完整病历和随访资料的肝囊性包虫病患者,包括患者诊疗医院、病例鉴定方法、手术年份、病变分类、病变数量、病变大小、病程、手术方式、术后随访资料等患者特征。按照《中央财政转移支付计划包虫病患者管理指南》对肝囊性包虫病的治愈率和复发率进行评价,并计算治愈率和复发率。结果:收集1 686例肝囊性包虫病手术患者资料。根据纳入与排除标准,2006 - 2022年纳入手术治疗肝囊性包虫病患者1 222例,其中治愈1 166例(95.42%),术后复发88例(7.20%),2008 - 2022年肝囊性包虫病患者手术治疗治愈率呈上升趋势(χ2趋势= 19.39,P < 0.05)。定期体检、中央财政棘球蚴病控制转移支付项目筛查和被动就诊患者的肝囊性棘球蚴病治愈率分别为100%(177/177)、94.81%(128/135)和94.62%(861/910),差异有统计学意义(χ2 = 9.95, P < 0.05)。病程2年及以下患者的肝囊性包虫病治愈率为95.96%(1 046/1 090),病程2年以上患者的治愈率为90.90% (120/132)(χ2 = 6.87, P < 0.05),且肝囊性包虫病患者的治愈率在病变数(χ2 = 24.44, P < 0.05)和手术方式(P < 0.05)方面差异均有统计学意义。实施中央财政棘球蚴病防治转移支付项目后,肝囊性棘球蚴病治愈率(96.06%,1 096/1 141)显著高于实施前(86.42%,70/81)(χ2 = 16.06, P < 0.05),定点医院肝囊性棘球蚴病治愈率(96.48%,741/768)显著高于非定点医院(93.37%,366/392)(χ2 = 5.78, P < 0.05)。1222例肝囊包虫病手术治疗患者中位随访时间为4年(四分位间距为7年)。2008 - 2022年肝囊性包虫病复发率呈下降趋势(χ2趋势= 36.86,P < 0.05),由2008年的23.08%(9/39)下降至2021年的1.85%(1/54),实施中央财政包虫病防治转移支付计划后肝囊性包虫病术后复发率(5.87%,67 / 1 141)低于实施计划前的25.93%,21/81 (χ2 = 45.51, P < 0.05)。非定点医院肝囊性包虫病术后复发率(10.46%,41/392)高于定点医院(5.60%,43/768)(χ2 = 9.12, P < 0.05),不同手术方式肝囊性包虫病患者术后复发率差异有统计学意义(P < 0.05)。以经皮细针抽吸囊肿液为基础的外科手术患者复发率最高(11.54%)(P < 0.05)。结论:自2006年甘肃省启动中央财政棘球蚴病控制转移支付项目以来,肝囊性棘球蚴病患者手术治愈率提高,复发率降低,总体疗效较高。
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来源期刊
中国血吸虫病防治杂志
中国血吸虫病防治杂志 Medicine-Medicine (all)
CiteScore
1.30
自引率
0.00%
发文量
7021
期刊介绍: Chinese Journal of Schistosomiasis Control (ISSN: 1005-6661, CN: 32-1374/R), founded in 1989, is a technical and scientific journal under the supervision of Jiangsu Provincial Health Commission and organised by Jiangsu Institute of Schistosomiasis Control. It is a scientific and technical journal under the supervision of Jiangsu Provincial Health Commission and sponsored by Jiangsu Institute of Schistosomiasis Prevention and Control. The journal carries out the policy of prevention-oriented, control-oriented, nationwide and grassroots, adheres to the tenet of scientific research service for the prevention and treatment of schistosomiasis and other parasitic diseases, and mainly publishes academic papers reflecting the latest achievements and dynamics of prevention and treatment of schistosomiasis and other parasitic diseases, scientific research and management, etc. The main columns are Guest Contributions, Experts‘ Commentary, Experts’ Perspectives, Experts' Forums, Theses, Prevention and Treatment Research, Experimental Research, The main columns include Guest Contributions, Expert Commentaries, Expert Perspectives, Expert Forums, Treatises, Prevention and Control Studies, Experimental Studies, Clinical Studies, Prevention and Control Experiences, Prevention and Control Management, Reviews, Case Reports, and Information, etc. The journal is a useful reference material for the professional and technical personnel of schistosomiasis and parasitic disease prevention and control research, management workers, and teachers and students of medical schools.    The journal is now included in important domestic databases, such as Chinese Core List (8th edition), China Science Citation Database (Core Edition), China Science and Technology Core Journals (Statistical Source Journals), and is also included in MEDLINE/PubMed, Scopus, EBSCO, Chemical Abstract, Embase, Zoological Record, JSTChina, Ulrichsweb, Western Pacific Region Index Medicus, CABI and other international authoritative databases.
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