小儿肝囊型包虫病152例临床特征及诊治分析  

Analysis of clinical characteristics and treatment 152 cases of pediatric patients with hepatic cystic echinococcosis

作　　者：阿斯古丽·热依木 李万富[2] 马柱[2] 梁挺[2] 樊伽榕 Asigulireyimu;Li Wanfu;Ma Zhu;Liang Ting;Fan Jiarong(First Clinical College,First Affiliated Hospital,Xinxiang Medical University,Urumqi 830011,China;Department of Pediatric Surgery,First Affiliated Hospital,Xinxiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一临床学院,新疆维吾尔自治区乌鲁木齐市830011 [2]新疆医科大学第一附属医院小儿外科二科,新疆维吾尔自治区乌鲁木齐市830011

出　　处：《临床小儿外科杂志》2019年第4期310-314,共5页Journal of Clinical Pediatric Surgery

基　　金：新疆维吾尔自治区自然科学基金(编号:2017D01C321)

摘　　要：目的探讨小儿肝囊型包虫病的临床特点及诊治经验。方法回顾性分析2010年1月至2017年1月由新疆医科大学第一附属医院收治的152例肝囊型包虫病患儿的临床资料,对其临床表现、类型、诊断及治疗方法进行总结分析。结果本组152例患儿,其中肝内多发性包虫病52例,合并其他脏器包虫病26例,复发包虫病4例。病变部位多位于右半肝,多因右上腹疼痛、腹胀或体检时发现。手术治疗149例,药物治疗3例。其中行内囊摘除+外囊次全切除术97例,行外囊完整剥离术18例,行单纯内囊摘除术34例。所有患儿随访1~2年,经手术治疗的患儿均痊愈,无复发,术后残腔积液19例,其中合并感染5例,经药物治疗后均痊愈。药物治疗的患儿2例治疗6个月后予手术治疗,1例治疗后随访建议继续药物治疗。结论小儿囊型包虫具有生长速度较快、易肝内多发包虫、多脏器包虫、易破裂等特点。以手术治疗为主,药物治疗为辅。外生型囊型包虫病首选内囊摘除+外囊次全切除术,单纯肝内型囊型包虫病首选单纯内囊摘除术。Objective To explore the clinical characteristics,diagnosis and treatment of hepatic cystic echinococosis in children.Methods The clinical data of 152 pediatric patients with hepatic cystic echinococcosis were analyzed.Their clinical characteristics,manifestations,types,diagnosis and treatment were retrospectively reviewed.Results All patients included intrahepatic multiple cystic echinococcosis(n=52),hydatid disease involving other organs(n=26)and recurrent echinococcosis(n=4).Most sites were located in right half liver and there were right epigastric pain,abdominal distention and detection during physical examination.Among them,149 patients were operated and 3 patients received medications.The follow-up period was 1-2 years.All operated patients were cured without recurrence.Among 19 cases of postoperative residual cavity effusion,5 cases were complicated with infection,and then treated with drugs.Among those medicated ones,2 were re-operated after 6 months and 1 received continued drug therapy.Conclusion Hydatid cyst in children has the unique characteristics of fast growth,easy occurrence of multiple haydatid cyst,multiple organ echinococcosis and easy rupture.Surgical treatment is primary while drug therapy remains secondary.According to the different growth periods of echinococcosis,the first choice of surgical methods is different.Removal of internal capsule plus subtotal resection of external capsule is the best choice for exogenous hepatic cystic echinococcosis while simple internal capsule extirpation is indicated for endogenetic hepatic cystic echinococcosis.

关 键 词：棘球蚴病 肝/诊断 棘球蚴病 肝/外科学 儿童 

分 类 号：R729[医药卫生—儿科] R532.32[医药卫生—临床医学]