肝囊性包虫病外囊完整摘除术治疗肝包虫病的疗效及安全性分析  

Analysis on efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis

作　　者：马智[1,2] 魏耕富 史屹洋 陈哲宇 MA Zhi;WEI Gengfu;SHI Yiyang;CHEN Zheyu(Department of Hepatobiliary Surgery,Hydatid Treatment Center,Ganzi Tibetan Autonomous Prefecture People’s Hospital,Kangding,Sichuan 626000,P.R.China;Sichuan Clinical Research Center for Hydatidosis,Kangding,Sichuan 626000,P.R.China;Department of Liver And Vascular Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]甘孜藏族自治州人民医院肝胆外科包虫治疗中心,四川康定626000 [2]四川省包虫病临床医学研究中心,四川康定626000 [3]四川大学华西医院肝脏外科,成都610041

出　　处：《中国普外基础与临床杂志》2020年第1期34-37,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省卫生厅科研课题(项目编号：169151);四川省科技厅重点研发项目(项目编号：2019YFS0029);四川省科技计划项目(项目编号：2019YFS0529)

摘　　要：目的分析肝囊性包虫病外囊完整摘除术治疗肝包虫病的疗效及安全性。方法回顾性分析甘孜藏族自治州人民医院2016年1月至2018年3月期间收治的90例肝囊性包虫病患者的临床资料。根据手术方式不同分为肝切除组(简称切除组)和包虫外囊完整摘除组(简称摘除组),2组各45例。对2组患者一般情况及住院期间情况进行分析,并对不同手术方式的术中情况、治疗后并发症情况以及术后1年内的复发及死亡率进行比较。结果切除组的手术时间和术中出血量明显长于或多于摘除组(P<0.05);在住院时间上2组比较差异无统计学意义(P>0.05);切除组患者术后并发症发生率为11.11%(5/45),摘除组为8.88%(4/45),2组比较差异无统计学意义(P>0.05);术后1年随访,切除组的复发率为4.44%(2/45),摘除组患者无复发,2组患者均无死亡情况出现,2组比较差异无统计学意义(P>0.05)。结论肝囊性包虫病手术治疗临床上需根据患者具体情况选择最合适的手术方法;外囊完整摘除术在治疗肝包虫病上有着较高的治疗效果及安全性,值得临床推广。Objective To analyze the efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis. Methods The clinical data of 90 patients with hepatic cystic echinococcosis admitted to our hospital from January 2016 to March 2018 were retrospectively analyzed. According to the different surgical methods, this patients were divided into two groups: the partial hepatectomy group and complete excision of the external capsule group, 45 cases in each group. The patient’s general condition and the situation during hospitalization were analyzed, and the intraoperative conditions, postoperative complications, recurrence and mortality after one year in different surgical methods were compared. Results The operative time and intraoperative blood loss in the partial hepatectomy group was significantly longer or more than that in the complete excision of the external capsule group(P<0.05), respectively. There was no significant difference between the two groups in hospitalization time(P>0.05). The incidence of postoperative complications was 11.11% in the partial hepatectomy group and 8.88% in the complete excision of the external capsule group. There was no significant difference between the two groups(P>0.05). After 1 year of followed-up, the recurrence rate of the partial hepatectomy group was 4.44%, and there was no recurrence in the complete excision of the external capsule group, and there was no significant difference between the two groups(P>0.05). There wasno death in both groups. Conclusions In the surgical treatment of hepatic cystic echinococcosis, the most appropriate surgical method should be selected according to the specific conditions of the patient, and the complete excision of the external capsule has higher therapeutic effect and safety in the treatment of hepatic echinococcosis. It is worthy of clinical promotion.

关 键 词：肝囊性包虫病 外囊完整摘除术 疗效 安全性 肝部分切除术 

分 类 号：R657.3[医药卫生—外科学]