肝脏囊型包虫病腹腔镜与开腹根治性手术治疗的疗效比较  

Laparoscopic vs conventional open resection of liver hydatid cyst

作　　者：马尔旦·马合木提 邰沁文[1] 吐尔干艾力·阿吉[1] 吐尔洪江·吐逊[1] 曹俊[1] 赵晋明[1] 张金辉[1] 

机构地区：[1]新疆医科大学第一附属医院消化血管外科中心 肝脏移植腹腔镜外科,乌鲁木齐830054

出　　处：《中华普通外科杂志》2014年第12期941-944,共4页Chinese Journal of General Surgery

基　　金：卫生部“临床重点专科”地方病（包虫病）建设基金资助项目;国家临床重点专科建设基金资助项目;新疆维吾尔自治区自然科学青年基金资助项目（2014211C081）

摘　　要：目的评价和比较经腹腔镜与开腹根治性手术治疗肝脏囊型包虫病的临床疗效。方法回顾性分析2006年5月至2013年1月收住并接受根治性手术治疗的肝脏囊型包虫病患者的临床资料，并对手术时间、术中出血量、中转开腹率、平均术后住院时间、术后并发症进行统计学分析。结果本研究共纳入153例患者，其中41例行经腹腔镜手术（腹腔镜组）、112例行传统开腹手术（开腹组）。腹腔镜组平均手术时间较开腹手术短，但差异无统计学意义（t=1．97，P〉0．05）。腹腔镜组5例患者行中转开腹手术，中转开腹率为12．2％（5／41）。2组术中出血量比较差异无统计学意义（t=2．00，P〉0．05）。腹腔镜组平均术后住院时间为3～8d，而开腹组为4—14d，差异有统计学意义（t=1．99，P〈0．05）。腹腔镜组并发症发生率为4．9％（2／41）、开腹组并发症发生率16．0％（18／112），差异有统计学意义（χ^2=3．92，P〈0．05）。结论腹腔镜肝包虫根治性手术治疗较传统开腹肝脏囊型包虫病手术治疗具有术后住院时间短，并发症少，恢复快，复发率低的特点，在严格选择患者的条件下是安全和可行的。Objeetive To evaluate laparoscopic radical resection of liver hydatid cyst as compared with conventional open surgery. Methods From May 2006 to January 2013 clinical data of 41 patients undergoing laparoscopie radical resection of hepatic hydatid cyst were compared with those 112 cases treated by open surgery. Operation time, blood loss, conversion rate, length of hospitalization and recurrence rate were compared and analyzed. Results There was not statistical significant difference in operative time and blood loss between the two groups （ t = 1.97, P 〉 0.05 ） （ t = 2. 00, P 〉 0.05 ）. Five laparoscopic patients were converted to open surgery, conversion rate was 12. 2 % （5/41）, three due to inadequate exposure, and two for intraoperative bleeding. Postoperative hospital stay was significantly shorter in laparoscopic group than that in conventional group. The overall morbidity was 4. 9% （2/41） in laparoscopic and 16. 0% （18/112） in conventional group with statistical significance （χ^2 = 3.92, P 〈 0.05 ）. Recurrence rate and mortality was 0 in both groups. Conehtsions Laparoscopic radical resection of hydatid cyst is safe and effective in carefully selected patients and provides short hospital stay, good cosmetic result, fast recovery and fewer complications.

关 键 词：棘球蚴病 肝 腹腔镜 根治性切除 

分 类 号：R532.32[医药卫生—内科学] R657.3[医药卫生—临床医学]