儿童肺包虫病外囊完整切除术的临床疗效分析  

Clinical outcomes of complete pericystectomy in children with pulmonary hydatid disease

作　　者：张国明[1] 何丽芸[2] 艾力亚尔·克依木 阿扎玛提·阿扎提 晋小闯[1] 阿曼吐尔·介恩什 张力为[3] 伊地力斯·阿吾提[3] Zhang Guoming;He Liyun;Ailiyaer·Keyimu;Azhamati·Azhati;Jin Xiaochuang;Amantuer·Jieenshi;Zhang Liwei;Yidilisi·Awuti(Department of Pediatric Cardiothoracic Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China;Central Operating Room,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China;Department of Thoracic Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院小儿心胸外科,乌鲁木齐830011 [2]新疆医科大学第一附属医院中心手术室,乌鲁木齐830011 [3]新疆医科大学第一附属医院胸外科,乌鲁木齐830011

出　　处：《中华小儿外科杂志》2023年第8期732-735,共4页Chinese Journal of Pediatric Surgery

基　　金：2021年新疆维吾尔自治区科技计划(2021D01C329)。

摘　　要：目的探讨儿童肺包虫外囊完整切除术的手术治疗效果。方法选取2013年4月至2019年6月新疆医科大学第一附属医院收治的单纯性无破裂感染肺包虫病96例患儿的临床资料,其中男51例,女45例;平均年龄为6.6岁,范围为3~14岁。胸部X线片及CT检查结果显示:右肺包虫54例(上叶23例、中叶9例、下叶22例),左肺包虫42例(上叶20例、下叶22例)。根据术式的不同将患儿分为:外囊完整切除术组(A组)、内囊完整摘除术组(B组)、穿刺内囊摘除术组(C组)、肺楔形内外囊切除术组(D组),对比手术时间、出血量、术后带管时间、住院时间及并发症和复发率。结果术后没有支气管胸膜漏及包虫复发的情况。A组和D组的手术时间、术中出血量、带管时间和住院时间明显少于B和C组(P<0.05);A组和D组的气胸、胸腔积液、残腔积液感染、肺不张等术后并发症发生率明显少于B组和C组(P<0.05)。结论肺包虫外囊完整切除术术后并发症及复发率极低,避免了正常肺组织的切除,是一种安全、有效的根治性术式,值得临床推广应用。Objective To explore the surgical outcomes of complete excision of pulmonary ectohydatid sac in children.Methods From April 2013 to June 2019,clinical data were retrospectively reviewed for 96 children with simple non-ruptured infection of pulmonary echinococcosis.There were 51 boys and 45 girls with an age range of(3-14)years.Chest radiography and computed tomography(CT)examination revealed right lung hydatid(n=54)(upper lobe,n=23;middle lobe,n=9;lower lobe,n=22)and left lung hydatid(n=42)(upper lobe,n=20;lower lobe,n=22).According to the different operative approaches,they were divided into four groups of complete extracapsular resection(group A),complete extracapsular resection(group B),puncture extracapsular resection(group C)and wedged-shaped extracapsular resection(group D).Operative duration,volume of blood loss,postoperative catheter duration,hospital stay,complications and recurrence rate were compared.Results There was no postoperative recurrence of bronchopleural leakage or hydatid.Operative duration,intraoperative blood loss,catheter time and hospital stay were significantly less in group A/D than those in group B/C(P<0.05).The incidence of postoperative complications such as pneumothorax,pleural effusion,infection of residual effusion and atelectasis was significantly lower in group A/D than that in group B/C(P<0.05).Conclusions The complication/recurrent rate of complete excision of pulmonary echinohydatid sac is quite low,avoiding an excision of normal lung tissue.As a safe and effective radical operation,it is worthy of wider clinical applications.

关 键 词：棘球蚴病 肺 肺部分切除术 手术后并发症 

分 类 号：R726.5[医药卫生—儿科]