肝泡状棘球蚴病治疗探讨(附36例报告)  

Redearch for The Treatment of Liver Alveoiar Hydatld Disease—A Report of 36 Cases

作　　者：李俊 邹培范 杨文光[1] 温浩[1] 王云海[1] 杨含维[1] 

机构地区：[1]新疆医学院第一附属医院普外科

出　　处：《新疆医学院学报》1993年第3期238-242,278-279,共5页

基　　金：新疆维吾尔自治区自治区卫生厅青年科研基金

摘　　要：本文总结了我院1983～1992年收治的肝泡状棘球蚴病36例的治疗经验。我们认为根治性病变切除是最为理想的治疗方法;部分病变切除,解除胆道及血管压迫,结合手术前后化疗对晚期肝泡状棘球蚴病是有效、可行的治疗措施,有希望在大多数肝泡状棘球蚴病患者取得理想的治疗效果。吡喹酮和丙硫咪唑对泡状棘球蚴病具有肯定的治疗效果,结合外科手术治疗肝泡状棘球蚴病效果将更为理想。Alveolar hydatid disease (AHD), caused by larvae of Echnococcus multilocularis, is one of harmful disease to human being, and characterised by infiltrated growth, metastasis and poor prognosis. During the years 1983 through 1992, 36 patients suffered from AHD were treated with praziquantel、albendazole and combining with surgical operation. All the patients were dull. The age from 15 to 58. There were 22 male and 14 female. The diagnosis of all the patients was confirmed by histological examination except 2 cases with typical feature of AHD. The lesions of all the patients were originally located in the liver. 9 cases in the center of the lesions of the liver, necrosis cavity occurred. In 11 cases, the hepatic hilum was involved and had ob- structive jaundice, 10 cases with lung metastasis, 3 cases with brain metastasis, 3 cases with pancreas lesions. Complication of portal hypertension occurred in 5 cases. one case was suffered with cystic hydatid disease simultaneously. All the patients were followed up for 1-10 years. Surgical therapy: Among 36 cases, hemihepalectomy was performed in 4 cases and showed a good prognosis with no recurrence. Resection of the greater part of the mass was done in 18 cases and 6 of them were given choledochoplasty by putting a duct into the bile duct. 4 of 18 cases died of operative complication in one year. Drainage of necrosis cavity was carried out in 4 cases, only one was improved, two patients were died of infection of necrosis cavity or secondary hemorrhage respectively, one committed suicide. 8 cases had only exploratory laparotomy with biopsy and two were not received any operation, 8 cases of them died. One died within a month of surgery and was defined as operative death. Chemotherapy: 35 patients had been treated with praziquantel、albendazole respectively, or combined, 22 cases were treated with praziquantel alone. Praziquantel was given orally in a daily dose of 25mg/kg or 50mg/kg, for 10、20 and 30 ds as a course. This drug was usually given 2 or 3 courses with one

关 键 词：肝棘球蚴病 切除术 药物疗法 

分 类 号：R532.320.5[医药卫生—内科学]