非寄生虫性肝囊肿临床特征及干预治疗影响因素分析  

Analysis of clinical characteristics of non-parasitic hepatic cysts and influencing factors for therapies

作　　者：马锋[1] 冯文宇 张谞丰[1,3] 牟怡平[4] 刘学民[1,3] 李宇[1,3] 张晓刚[1,3] 仵正[1,3] 王博[1,3] 吴荣谦[1] 于良[1,3] 李强[2] 吕毅 Ma Feng;Feng Wenyu;Zhang Xufeng;Mou Yiping;Liu Xuemin;Li Yu;Zhang Xiaogang;Wu Zheng;Wang Bo;Wu Rongqian;Yu Liang;Li Qiang;Lyu Yi(National and Local Joint Engineering Research Center of Precision Surgery and Regenerative Medicine,Shaanxi Provincial Research Center for Regenerative Medicine and Surgical Engineering,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Epidemiology and Health Statistics,School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061,China;Department of Hepatobiliary Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Medical Information Management Office,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心陕西省再生医学与外科工程研究中心,710061 [2]西安交通大学医学部公共卫生学院流行病与卫生统计教研室,710061 [3]西安交通大学第一附属医院肝胆外科,710061 [4]西安交通大学第一附属医院医疗信息管理办公室,710061

出　　处：《中华肝脏外科手术学电子杂志》2021年第3期314-317,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：陕西省科技厅重点研发计划项目(2019ZDLSF01-02-02);西安交通大学第一附属医院新医疗新技术项目(XJYFY-2018ZD1)。

摘　　要：目的探讨非寄生虫性肝囊肿临床特点、治疗及影响干预治疗的因素。方法回顾性分析2008年1月至2020年4月西安交通大学第一附属医院收治的591例非寄生虫性肝囊肿患者临床资料。患者签署知情同意书,符合医学伦理学规定。记录患者人口学资料及临床特征,包括年龄、性别、囊肿大小、囊肿位置、治疗方式等。治疗的影响因素分析采用多因素Logistic回归分析。结果男性患者占39.4%(233/591),女性占60.6%(358/591);年龄50~70岁,中位年龄61岁。单发性肝囊肿194例,多发性肝囊肿397例。有临床症状者占56.5%(334/591),主要症状为腹痛、腹胀。治疗干预494例,其中超声引导下肝囊肿穿刺抽吸57例,腹腔镜肝囊肿开窗引流术369例,开腹肝囊肿开窗引流术68例。囊肿直径≥8 cm是疗效的独立影响因素(OR=5.471,95%CI:3.347~8.942;P<0.05)。结论非寄生虫性肝囊肿好发于中老年女性患者,所有患者均以多发囊肿为主。开窗引流术为主要治疗方式,对于肝囊肿直径≥8 cm建议积极治疗。Objective To investigate the clinical characteristics,treatments and influencing factors for the therapies of non-parasitic hepatic cysts.Methods Clinical data of 591 patients with nonparasitic hepatic cysts admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2008 to April 2020 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Demographic data and clinical characteristics including age,sex,cyst size,cyst location and treatments were recorded.The influencing factors of treatments were analyzed by multivariate Logistic regression analysis.Results Among them,the proportion of male patients was 39.4%(233/591)and 60.6%(358/591)for the female counterparts,all aged from 50 to 70 years with a median age of 61 years.194 patients were diagnosed with single hepatic cyst and 397 cases with multiple hepatic cysts.The proportion of patients presenting with clinical symptoms was 56.5%(334/591).The main symptoms included abdominal pain and distension.494 patients received treatments,including 57 cases of ultrasoundguided hepatic cyst aspiration,369 cases of laparoscopic hepatic cyst fenestration and drainage and 68 cases of open hepatic cyst fenestration and drainage.The cyst diameter of ≥8 cm was an independent influencing factor for the therapeutic effect(OR=5.471,95%CI:3.347-8.942;P<0.05).Conclusions Non-parasitic hepatic cysts are more prevalent in middle-aged and elderly women,and patients are mainly with multiple lesions.Fenestration and drainage is the primary treatment.Active treatment is recommended for the hepatic cyst with a diameter of≥8 cm.

关 键 词：非寄生虫性肝囊肿 腹腔镜 开窗术 引流术 

分 类 号：R575.8[医药卫生—消化系统]