摘要
目的探讨肝包虫囊肿破裂的相关因素及疗效。方法计算机检索1988年1月至2014年12月在Pub Med、ISI Web of Knowledge、CNKI、Google Scholar、EMBASE、万方数据库、维普公开发表的关于肝包虫囊肿破裂文献50篇。中英文检索词:肝包虫囊肿、破裂、hydatid cyst echinococcosis、rupture。纳入27篇文献分析,包括国外9篇,国内18篇,共2 511例,其中发生肝包虫囊肿破裂731例。分析囊肿破裂的相关因素、诊治措施及疗效。结果 731例肝包虫囊肿破裂患者中,男467例,女264例;年龄11~69岁,中位年龄32岁。中国690例,土耳其25例,印度15例,非洲1例。囊肿位于肝右叶者200例,肝左叶36例,未提供者495例。发生破裂的囊肿直径>10 cm者103例,5~10 cm者8例,未提供者620例。外伤性破裂93例,自发性破裂42例,医源性破裂4例,腹内压增高2例,未提供者590例。处理以急诊手术为主,破入胆道者以胆道清洗+T管引流为主;破入腹腔者以内囊摘除术、肝部分切除术+腹腔灌洗为主。术后多使用阿苯达唑1.5~12.0个月。术后随访时间0.5~4.0年。随访期间复发28例,未复发404例,未提供者299例。存活447例,误诊、死亡22例,未提供者262例。结论肝包虫囊肿破裂多见于流行地区中青年男性,位于肝右叶、囊肿直径>10 cm、外伤为破裂的主要相关因素;紧急手术彻底清除病灶及囊液是治疗关键,术后应用阿苯达唑可有效预防肝包虫囊肿复发。
Objective To investigate the relevant factors and treatment effect of liver hydatid cystrupture.Methods Fifty literatures related to liver hydatid cyst rupture published between January1988andDecember2014were electronically retrieved from PubMed,ISI Web of Knowledge,CNKI,Google Scholar,EMBASE,Wanfang database and VIP database.The Chinese and English keywords were liver hydatidcyst,hydatid cyst echinococcosis and rupture.Twenty-seven literatures consisted of9foreign studies and18domestic studies.Among2511patients,731cases were diagnosed with liver hydatid cyst rupture.Therelevant factors,diagnostic and therapeutic measures and treatment effect of liver hydatid cyst rupture wereanalyzed.Results Among731patients with liver hydatid cyst rupture,467cases were male and264werefemale,aged11-69years old with a median age of32years old.Among them,690cases were from China,25from Turkey,15from India and1from Africa.The liver hydatid cysts of200cases were found in the rightlobe and36cases in the left lobe,while no information about495cases.103cases were found with the ruptured cysts diameter>10cm,8cases were5-10cm,while no information about620cases.Among them,93cases werediagnosed with traumatic rupture,42with spontaneous rupture,4with iatrogenic rupture,2with intra-abdominalpressure elevation and no data in590.Emergency surgery was primarily adopted.Biliary tract irrigation combinedwith T catheter drainage was performed for patients with biliary tract involvement,and endocystectomy or partialhepatectomy combined with peritoneal lavage was performed for patients with abdominal cavity involvement.Postoperatively,albendazole was administered for1.5-12.0months in most patients.The postoperative followuptime was0.5-4.0years.During follow-up,liver hydatid cyst recurred in28cases,no recurrence in404andno data in299.For the treatment effect,447cases survived,22were misdiagnosed or died and no data in262.Conclusions Liver hydatid cyst rupture is mainly found in middle aged males in endemic area.Locating inthe right lobe of liver,cyst
作者
王瑞涛
李庆
梁欢
万永
董顺斌
曲凯
刘昌
Wang Ruitao;Li Qing;Liang Huan;Wan Yong;Dong Shunbin;Qu Kai;Liu Chang(Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China)
出处
《中华肝脏外科手术学电子杂志》
CAS
2017年第6期484-488,共5页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
陕西省社会发展科技攻关项目(2016SF-204)
关键词
棘球蚴病
肝
破裂
治疗结果
Echinococcosis, hepatic
Rupture
Treatment outcome
