CAJ | 학술논문

目的探讨肝囊型包虫引起的胆管支气管瘘(bronchobiliary fistula,BBF)的诊治疗效.方法新疆医科大学第一附属医院1992-2012年间收治肝囊型包虫病BBF患者39例,按收治时间分为A组(1992-2001年)、B组(2002-2012年),2组患者的治疗情况进行对比分析.结果 39例肝包虫囊肿并发支气管胆管瘘患者术后3例死亡,均为严重感染引起感染性休克.2组肝包虫囊肿并发支气管胆管瘘手术患者的年龄(=0.84,P=0.554)、性别构成(P=1.0)、每日痰量(t=0.98,P=0.703)、包虫直径(t=l.ll,P=0.406)、手术时间(t=0.451,P=0.651)、胸腔感染(P=1.0)、死亡率(P =0.235)等结果比较差异无统计学意义(P＞0.05).术中出血量(=2.73,P=0.01)、术后平均住院天数(t=7.64,P=0.000)、术后残腔并发症(P =0.001)、术后带管引流时间(t=6.747,P=0.01)、复发率(P =0.022)、胸腔播散种植(P=O.018)、再次手术率(P =0.049)等指标B组明显优于A组,2组比较差异有统计学意义(P＜0.05).结论肝囊型包虫引起的胆管支气管瘘目前仍然以手术为首选治疗手段,应尽可能行一次性手术.
목적 탐토간낭형포충인기적담관지기관루(bronchobiliary fistula,BBF)적진치료효.방법 신강의과대학제일부속의원1992-2012년간수치간낭형포충병BBF환자39례,안수치시간분위A조(1992-2001년)、B조(2002-2012년),2조환자적치료정황진행대비분석.결과 39례간포충낭종병발지기관담관루환자술후3례사망,균위엄중감염인기감염성휴극.2조간포충낭종병발지기관담관루수술환자적년령(=0.84,P=0.554)、성별구성(P=1.0)、매일담량(t=0.98,P=0.703)、포충직경(t=l.ll,P=0.406)、수술시간(t=0.451,P=0.651)、흉강감염(P=1.0)、사망솔(P =0.235)등결과비교차이무통계학의의(P＞0.05).술중출혈량(=2.73,P=0.01)、술후평균주원천수(t=7.64,P=0.000)、술후잔강병발증(P =0.001)、술후대관인류시간(t=6.747,P=0.01)、복발솔(P =0.022)、흉강파산충식(P=O.018)、재차수술솔(P =0.049)등지표B조명현우우A조,2조비교차이유통계학의의(P＜0.05).결론 간낭형포충인기적담관지기관루목전잉연이수술위수선치료수단,응진가능행일차성수술.
Objective To explore the diagnosis and treatment efficacy of bronchobiliary fistula due to hepatic cystic echinococcosis.Methods A retrospective evaluation of 39 patients with BBF was performed during 1992 to 2012.We divided the 39 patients into group A treated before 2001 and group B after 2002.A retrospective analysis was made.Results There were three deaths among the 39 BBF patients due to hepatic hydatid disease.The cause of death was septic shock due to severe infection.There were no statistical differences in the basic factors,age (t =0.84,P =0.554),gender (P =1.0),and sputum volume (t =0.98,P =0.703),hydatid diameter (t =1.11,P =0.406),operation time,chest infection (P =1.0),mortality (P =0.235) between the two groups (P ＞ 0.05).While postoperative length of stay(t =7.64,P =0.000),postoperative complications of residual cavity (P =0.001),length of tube drainage(t =6.747,P =0.01),recurrence of bronchial fistula (P =0.022),pleural dissemination (P =0.018),reoperation rate (P =0.049) were all in favour of group B (P ＜ 0.05).Conclusions Surgery is the choice of therapy for BBF due to hepatic hydatid disease,and one-stage procedure is expected to achieve the best outcomes.