儿童肝囊型包虫病腹腔镜手术治疗体会  

Treating experience of laparoscopic surgery for hepatic cystic echinococcosis in children

作　　者：阿布都赛米.阿布都热衣木 玉苏甫[1] 叶尔番 和军[1] 李凯[1] 刘东[1] 阿孜古丽[1] 周玲[1] 李水学[1] 克力木[2] Abudusaimi·Abudureyimu;Yusufu;Yeerfan;He Jun;Li Kai;Liu Dong;Aziguli;Zhou Ling;Li Shuixue;Kelimu(Department Pediatric Surgery,People's Hospital of Xinjiang Uigur Autonomous Region,830001 Urumqi,China;Department of Minimally Invasive Surgery for Abdominal Hernia,People's Hospital of Xinjiang Uigur Autonomous Region,830001 Urumqi,China)

机构地区：[1]新疆维吾尔自治区人民医院小儿外科,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院腹壁疝微创外科,乌鲁木齐830001

出　　处：《中华肝脏外科手术学电子杂志》2019年第1期54-57,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：卫生行业科研专项项目(2006BAI05A06)

摘　　要：目的探讨腹腔镜手术治疗儿童肝囊型包虫病的安全性和应用价值。方法回顾性分析2013年1月至2017年9月在新疆维吾尔自治区人民医院行腹腔镜手术的15例儿童肝囊型包虫病患者临床资料。患者家属均签署知情同意书,符合医学伦理学规定。其中男10例,女5例;年龄3～12岁,中位年龄8岁。单发包虫囊肿9例,多发囊肿6例。采用腹腔镜下内囊摘除及外囊剥除,穿刺抽液后用10%氯化钠液浸泡囊壁。观察患者围手术期及预后情况。结果 15例儿童肝囊型包虫病均在腹腔镜下顺利完成手术,其中行外囊剥除6例,外囊剥除联合内囊摘除9例。手术时间中位数75(55～140)min,术中出血量6(5～15)ml。术后2例患者出现胆漏,保守治疗后治愈。术后住院时间9(5～12)d。术后口服阿苯达唑预防复发。术后随访2～9个月,未见肝脏及盆腹腔包虫复发。结论腹腔镜手术治疗儿童肝囊型包虫病是安全、可行的,手术视野清楚、创伤小、术后恢复快、切口美观、住院时间短,对学龄期儿童的上学读书影响不大,家属容易接受。Objective To evaluate the safety and application value of laparoscopic surgery for hepatic cystic echinococcosis in children.Methods Clinical data of 15 children with hepatic cystic echinococcosis undergoing laparoscopic surgery in People's Hospital of Xinjiang Uigur Autonomous Region from January 2013 to September 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,10 patients were male and 5 were female,aged 3-12 years with a median age of 8 years.Nine patients were with single hepatic cystic echinococcosis and 6 with multiple hepatic cystic echinococcosis.Laparoscopic resection of the internal and external cysts was performed.The capsular wall was soaked with 10%sodium chloride solution after centesis.The perioperative situation and prognosis of the patients were analyzed.Results All 15 children with hepatic cystic echinococcosis underwent laparoscopic surgery successfully,including 6 cases receiving external cystectomy and 9 external combined with internal cystectomy.The median operation time was 75(55-140)min and the intraoperative blood loss was 6(5-15)ml.Bile leakage occurred in 2 children after operation and was cured by conservative treatments.The length of postoperative hospital stay was 9(5-12)d.Oral albendazole was given to prevent recurrence.During the postoperative 2-9 month follow-up,no recurrence of echinococcosis was observed in the liver and pelvic cavity.Conclusions Laparoscopic surgery is safe and feasible treatment for hepatic cystic echinococcosis in children,which possesses advantages of clear surgical field,minimal invasion,quick postoperative recovery,nice incision and short hospital stay.It has small impact on the school-age children and is more likely to be accepted by parents.

关 键 词：儿童 棘球蚴病 肝 腹腔镜 

分 类 号：R726.5[医药卫生—儿科]