同期联合手术治疗肝肾囊型棘球蚴病11例临床分析  

Simultaneous combined surgery for hepatic and renal cystic echinococcosis:a study on 11 cases

作　　者：艾斯卡·艾尼娃阿 卜杜萨拉木·艾尼 喀斯木·艾海提 冉博 蒋铁民 郭强 邵英梅 温浩 吐尔干艾力·阿吉 Aisika·Ainiwa null;Abudusalamu·Aini null;Kasimu·Aihaiti null;Ran Bo;Jiang Tiemin;Guo Qiang;Shao Yingmei;Wen Hao;Tuerganaili·Aji null(Hepatobiallary and Echincoccosis Surgery Department,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases,Digestive and Vascular Surgery Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;State Key Laboratory of Pathogenesis,Prevention and Management of High Incidence Diseases in Central Asia,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院普通外科,100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院影像科,100045

出　　处：《中华普通外科杂志》2021年第9期663-667,共5页Chinese Journal of General Surgery

基　　金：国家自然科学基金(81960377)。

摘　　要：目的:探讨同期联合手术治疗肝肾囊型棘球蚴病(cystic echinococcosis,CE)的可行性、安全性和有效性。方法:回顾性分析2009年10月至2017年2月在新疆医科大学第一附属医院连续收治并接受手术治疗的11例肝肾CE患者的临床资料。结果:患者中男8例、女3例,中位年龄44岁(22~60岁)。症状包括腹痛、腰痛、发热;肝+右肾病灶9例,肝+左肾病灶2例,病灶体积中位数944.1 cm 3(67.1~9310.4 cm 3)。采用同期联合手术治疗,术式包括外/内囊切除10例、肝/肾切除4例以及肝肾外病灶切除5例。手术均顺利,根治率为63.6%(7/11),术后未发生肝/肾功能不全,中位手术时长2.5 h(1.4~4.5 h)、中位出血量100 ml(50~200 ml)、中位住院天数7 d(5~10 d)。中位随访时长42个月(34~123个月),无死亡或疾病复发病例,均获得治愈。结论:采用同期联合手术治疗复发性或继发性肝肾CE安全、可行、有效,可一并切除其他临近器官的CE病灶,但需要根据具体情况个体化实施。Objective To investigate the feasibility,safety and efficacy of simultaneous combined surgery for hepatic and renal cystic echinococcosis(CE).Methods Clinical data of consecutive 11 hepatic and renal CE patients undergoing surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from Oct 2009 to Feb 2017 were analyzed retrospectively.Results There were 8 males and 3 females,median age was 44 years(22-60 years).Main symptoms were abdominal and/or flank pain and fever;nine and 2 patients respectively had cysts in liver plus right kidney and left kidney;median volume of cyst load for each patient was 944.1 cm3(67.1-9310.4 cm3).All patients were treated simultaneously by combined surgery,including total and subtotal cystectomies,hepatic or renal resections as well as extra lesions resection.All surgeries went uneventfully,radical rate was 63.6%(7/11),There was no postoperative liver or kidney dysfunctions.Median operative time,bleeding and length of hospital stay were 2.5 h(1.4-4.5 h),100 ml(50-200 ml)and 7 d(5-10 d)respectively.All were followed-up for median 42 mouths(34-123 mouths)and all doing well without disease recurrence.Conclusions Simultaneous combined surgery for recurrent or primary hepatic and renal double organ CE patients could be a feasible and effective approach.

关 键 词：棘球蚴病 外科手术 肝 肾 

分 类 号：R73[医药卫生—肿瘤]