手术治疗肝包虫病137例分析

摘要

目的 探讨肝包虫病不同情况的最佳手术治疗方式、适应证及疗效.方法 对我院2001年1月至2012年1月的137例肝包虫病患者的临床资料进行回顾性分析.结果 肝囊性包虫病115例(83.94％),其中内囊摘除、残腔引流术38例(27.74％),内囊摘除、外囊缝合闭锁16例(11.68％),外囊次全切除术8例(5.84％),外囊完整剥除术21例(15.33％),肝切除术32例(23.36％).肝泡型包虫病22例(16.06％),均行肝切除术.临床治愈136例(99.27％),死亡1例(0.73％).术后残腔积液11例(8.03％),胆漏18例(13.14％),外囊钙化不闭合2例(1.46％).116例随访0.5 ～9年,原位复发2例,其中死亡1例,其余患者均恢复良好.结论 肝包虫病5种手术方式各有优缺点,应根据肝包虫病的不同情况选择最佳术式.%Objective To investigate the best way for various surgicaI treatment manners of Iiver echinococcosis and their adaptations、efficacy.Methods We retrospectively analyzed the clinical data of 137 Iiver echinococcosis cases,from 1 2001 to 1.2012.Results 115 cases were belong to Cystic echinococcosis group (83.94％).among them,38 cases received internal capsule excision+residual cavity drainage(27.74％),16 cases receiced internal capsule excision+ closing of oter cysts by suture(11.68％),8 cases received sub-total cystectomy(5.84％),21 cases received total oter cystectomy(15.33％),32 cases received partial hepatectomy(23.36％).22 cases were belong to alveolar echinococcosis group(16.06％),all of them received partial hepatectomy.136 cases achieved clinical cure (99.27％),1 case was dead.Postoperation,11 patients with residual cavity effusion (8.03 ％),18 cases with bile leakage (13.14％),2 cases with oternal capsual calsification (1.46％),116 cases were followed from 0.5 ～ 9 years,2 cases with recurrence in situ,one of was dead,and the others get right.Conclusions The five kinds of operation mode to treat hepatic echinococcosis have different advantages and disadvantages.We should choose the best operation according to the different situation of hepatic echinococcosis.