CAJ | 학술논문

目的总结小儿肝囊性包虫病的诊断与外科治疗经验.方法回顾性分析中心2002年1月至2010年1月期间收治的67例14岁以下(包含14岁)肝囊性包虫病患儿,对其临床表现、治疗方法及术后并发症进行分析.结果 67例患儿均行手术治疗,行传统内囊摘除术47例,行完整外囊剥离术式11例,行外囊次全切除术6例,行肝叶切除术3例,术后肺部感染1例,1例患儿术后11d因反复应激性溃疡出血伴发多器官功能衰竭死亡,随访1～8年,包虫残腔积液7例,残腔积液合并感染2例,1例患儿术后3年包虫原位复发再次行手术治疗治愈.结论小儿肝囊性包虫具有生长快,囊壁薄,较易合并其他脏器等特点,超声、CT及实验室检查等可明确术前诊断,内囊摘除术为有效治疗肝囊性包虫术式,内囊次全切除术及术中胆道造影可有效降低术后残腔并发症.
목적 총결소인간낭성포충병적진단여외과치료경험.방법 회고성분석중심2002년1월지2010년1월기간수치적67례14세이하(포함14세)간낭성포충병환인,대기림상표현、치료방법급술후병발증진행분석.결과 67례환인균행수술치료,행전통내낭적제술47례,행완정외낭박리술식11례,행외낭차전절제술6례,행간협절제술3례,술후폐부감염1례,1례환인술후11d인반복응격성궤양출혈반발다기관공능쇠갈사망,수방1～8년,포충잔강적액7례,잔강적액합병감염2례,1례환인술후3년포충원위복발재차행수술치료치유.결론소인간낭성포충구유생장쾌,낭벽박,교역합병기타장기등특점,초성、CT급실험실검사등가명학술전진단,내낭적제술위유효치료간낭성포충술식,내낭차전절제술급술중담도조영가유효강저술후잔강병발증.
Objective The aim of this study was to summarize the diagnosis and surgical management for hepatic hydatid cysts in children.Methods The clinical data from 67 cases (less than 14year old) of hepatic hydatid cyst who underwent surgery in our centre were targeted,clinical manifes tations,imaging examination results and therapeutic efficacy as well as the postoperative complications in them,were retrospectively reviewed.Results All patients included 44 boys and 23 girls,the mean age 8.86 years old (ranging from 3 to 14 years).The cysts in 31 patients located in liver right lobe (46.27％),17 were in liver left lobe (25.37％),and 19 were in both lobes (28.36％ ).Single hepatic cysts were found in 35 patients (52.24％ ) and multiple hepatic cysts were seen in 32 patients (47.76％),11 cases of all patients were found accompanied cysts in other organs.All the patients underwent surgery,in which 47 cases were treated with conservative therapy,11 cases were for total pericystectomy and 3 cases were for liver resection.1 patient was complicated with pulmonary infection after surgery,7 cases and 2 cases were respectively complicated with cystic effusion and abscess.Furthermore,recurrent cysts were found in 1 patient and 1 children died due to multiple system organ failure.Conclusions Conservative surgery is still the important strategy for hepatic hydatid cysts,the subtotal pericystectomy and selective intraoperative cholangiography could contribute to reduce the complications caused by residual cavity.