摘要
目的:总结肝脏泡状棘球蚴病的诊治体会,提高肝脏泡状棘球蚴病的临床诊疗水平。方法:回顾分析11例肝脏泡状棘球蚴病患者病例。结果:11例患者中结合B超/CT/MRI等明确诊断8例,2例术前不能排除肝癌可能,1例误诊为血管瘤;实验室检查:谷丙转氨酶/谷草转氨酶升高6例(55%);碱性磷酸酶(AKP)升高5例(45%):总胆红素升高并直接胆红素升高8例(73%);甲胎蛋白(AFP)检测11例,2例轻度升高,余均阴性;11例患者均成功行手术治疗,4例行右半肝切除术(其中胆肠吻合1例),1例行右三叶切除术,5例行肝包虫切除术(其中联合胆囊切除2例),1例行姑息性手术;3-6个月后复查,3例患者局部复发,2例残腔少许积液,余6例患者术后恢复良好。结论:肝脏泡状棘球蚴病在肝实质内呈浸润性、外生性生长,瘤体中心出现液化无明显钙化时,在影像学方面容易导致误诊,该病手术难度较大,建议尽早手术,以根治术为主,可减少术后复发,取得较好治疗效果。
Alveolar Echinococcosis obiective;To review and summarize the clinical experience on the diagnosis and treatment of Hepatic Alveolar Echinococcosis and to improve the efficacy of treatment.Methods： 11 cases of hepatic alveolar echinococcosis were analyzed retrospectively.Results;Of the 11 patients,8 were diagnosed by ／i ultrasound/CT/MftI,in other two cases the possibility of liver cancer cant be ruled out prepoeratively and one case was misdiagnosed as hemangioma;laboratory tests;elevated alanine aminotransferase/aspartate aminotransferase in six cases（55%）;elevated alkaline phosphatase（A KP） in 5 cases（45%）;elevated total bilinibin and direct bilirubin in 8 cases（73%）;alpha - fetoprotein（AFP） were of slightly elevated in two of the 11 cases,in others it was negative;11 cases were successfully treated by surgery,4 cases underwent right lobe resection（biliary -enteric anastomosis in one case）,lease resection of a routine right trefoil,5 cases liver complete lesion excision（including joint cholecystectomy in 2 cases）,a case palliative surgery;by 3-6 months follow -up,three cases occurred local recurrence,two eases of residual cavity a little effusion,the remaining six cases of patients recovered well.Conclusion：The hydatid alvolar echinococcosis tends to grow exogenously by infiltrating the liver parenchyma,Sometimes with the central necrosis and liquefication.and,no cal- cification in imaging may leaa 10 misdiagnosis.Early diagnosis and early complete resection is of critical importance for the outcome of the disease.Pa（？）ve surgery is beneficial for reducing the lesion mass and for increasing the chances for other therapies,t
出处
《新疆医学》
2012年第10期36-41,共6页
Xinjiang Medical Journal
关键词
肝脏
泡状棘球蚴病
根治术
姑息性手术
liver Alveolar Echinococcosis radical surgery palliative surgery
