根治性与保守性手术治疗肝囊型包虫病疗效对比研究  

Comparative study of curative effect between radical and conservative surgery for hepatic cystic echinococcosis

作　　者：王铮 杨金煜[2] 盖志刚 王新昇[2] 周建平 王岩 朱海宏[2] WANG Zheng;YANG Jin-yu;GAI Zhi-gang(Graduate School of Qinghai University,Xining 810000,China;不详)

机构地区：[1]青海大学研究生院,青海西宁810000 [2]青海省人民医院肝胆外科,青海西宁810000

出　　处：《中国实用外科杂志》2023年第8期911-914,919,共5页Chinese Journal of Practical Surgery

基　　金：青海省卫生健康委员会项目(No.2021-wjzdx-17);2021年青海省“昆仑英才·高端创新创业人才”项目(No.青人才字[2021]13号)。

摘　　要：目的 探讨根治性手术(RS)与保守性手术(CS)治疗肝囊型包虫病(HCE)的临床疗效。方法 回顾性分析青海省人民医院2016年1月至2021年1月收治的行手术治疗的70例HCE病人的临床资料,根据手术治疗方式分为RS组(37例)和CS组(33例),比较两组病人的临床疗效。结果 RS组在手术时间、术中的出血量方面均大于CS组,术中发现胆瘘的病人比例低于CS组(P<0.05)。在术后腹腔引流管引流时间、胃肠道功能恢复时间、住院时间、残腔积液发生率、术后总体并发症发生率等方面RS组均低于CS组,差异均有统计学意义(P<0.05)。在术后切口感染、胆漏、腹腔/胸腔积液、过敏反应、呼吸道感染等并发症方面差异均无统计学意义(P>0.05)。随访时间内RS组无复发病人,CS组复发4例,RS组优于CS组,差异均有统计学意义(P<0.05)。结论 HCE行根治性手术优于保守性手术。在病人一般情况允许能耐受手术的前提下,根治性手术也许是一种更好的选择。Objective To investigate the curative effect of Radical Surgery(RS)and Conservative Surgery(CS)for hepatic cystic echinococcosis(HCE).Methods The clinical data of 70 patients with HCE who underwent surgical treatment and were admitted to Qinghai Provincial People's Hospital from January 2016 to January 2021 were retrospectively analyzed,including 37 cases in the RS group and 33 cases in the CS group,and clinical efficacy of the two groups was compared.Results The operative time and intraoperative blood loss in the RS group were greater than those in the CS group,and the proportion of patients with biliary fistula was lower than that in the CS group,and the differences were statistically significant(P<0.05).The postoperative drainage time of abdominal drainage tube,the recovery time of gastrointestinal function,length of hospital stay,the incidence of hydatid residual cavity effusion,and incidence of postoperative overall complications in the RS group was better than those in the CS group,and the differences were statistically significant(P<0.05).In postoperative incision infection,bile leakage,abdominal/pleural effusion,allergic reaction,respiratory tract infection and other complications,no statistical difference between two groups(P>0.05).There was no recurrence in the RS group and 4 recurrences in the CS group during the follow-up time,and the RS group was better than the CS group,and the differences were statistically significant.(P<0.05).Conclusion Radical surgery is better than conservative surgery for HCE,and radical surgery may be a better choice if patients can tolerate surgery.

关 键 词：肝细粒棘球蚴病 根治性手术 保守性手术 临床疗效 

分 类 号：R6[医药卫生—外科学]