842例胸部包虫囊肿的治疗

８４２例胸部包虫囊肿病人分别采用囊摘除术（７９％）、肺切除术（１２％）、引流及其它外科手术（９％）治疗，死亡率为０．６％；内囊摘除术后复发率为４．２％。３２３随访３一２０年，无１例死于胸包虫囊肿。术前用２种剂量吡喹酮治疗２２例，术时囊液内的原头蚴，死亡率分别为４３．１±９．６％　６４．２±３．５％较未服药对照组９．２±２．０％为高。作者认为内囊摘除术仍为目前最安全有效的措施。手术以前服用吡喹酮，可能对防止病人包虫囊肿复发有益。     

经腹腔镜行肝包虫囊肿内囊摘除术4例

自１９８７年Ｍｏｕｒｅｔ首次施行腹腔镜胆囊切除术以来,此项技术在世界范围内迅速开展,而且使用范围逐渐扩大．我院１９９４０７／１９９６０５对４例肝包虫囊肿患者施行腹腔镜手术．报告如下．１　材料和方法１．１　材料　本组４例中,男１例,女３例．年龄２０岁～６０岁,平均４３岁．２例有明确的犬或羊密切接触史,Ｃａｓｏｎｉ试验阳性３例．术前均经Ｂ超或ＣＴ诊断及定位．４例均为多发性囊肿．１．２　方法　采用气管插管静脉复合麻醉,仰卧位．于脐下缘切开１ｃｍ皮肤,用Ｖｅｒｅｓｓ针穿剌建立气腹,使腹内压维持在１－…     

CT导引下经皮穿刺硬化治疗肝包虫囊肿

我们自2000年以来开展了在CT导引下的经皮穿刺硬化治疗囊性肝包虫病，共治疗6例7个肝包虫囊肿，取得了较为满意的疗效，现总结报告如下。     

肝包虫囊肿胆瘘22例CT诊断探讨

目的复习经手术病理证实的肝包虫囊肿胆瘘的病例,提高对肝包虫囊肿胆瘘的认识.方法对22例经手术证实肝包虫囊肿胆瘘的CT病例进行了回顾性的分析.结果 22例肝包虫囊肿胆瘘者CT均见囊肿张力变小,形态不规则,内囊破裂明显19例.分别见显示为"新月征""囊中囊征"及"飘带样影".2例虽未见内囊破裂,胆囊内见散在的不规则气体影.1例囊壁局部略增后,囊内密度明显高于其他囊肿类密度. 结论术前CT诊断肝包虫囊肿胆瘘具有临床价值.     

大网膜移植加引流治疗肝包虫囊肿合并感染20例

1999～2002年,作者采用大网膜移植加引流治疗肝包虫囊肿合并感染20例,疗效满意,报告如下。1 临床资料 20例患者中,男性12例,女性8例。有高热寒颤病史2例,术前白细胞计数大于10×10~9/L、中性粒细胞升高5例,肝功能异常10例,Casoni试验阳性8例(阳性率为40％)。术前B超及CT检查包虫囊肿位于肝右叶14例,肝左叶6例。术中检查包虫囊肿长径最大15 cm,最小3 cm,平均1.5 cm;包虫囊内有不同程度的感染,合并胆瘘2例,术中囊液细菌培养,大肠埃希氏菌感染14例,金黄色葡萄球菌感染3例,厌气性链球菌感染1例,未见细菌感染2例。术前误诊为肝脓肿2例,     

肝囊肿与肝脓肿的腹腔镜外科处理

我科自1992年9月以来经电视腹腔镜治疗肝囊肿与肝脓肿38例,效果满意,现报告如下: 一、临床资料 本组男18例,女20例。年龄32～69岁,平均55.5岁。全组病例依据临床表现并经B超或CT证实诊断。32例肝囊肿直径4～24cm,Casoni试验阴性,除外寄生虫性肝囊     

肝包虫囊肿手术摘除后残腔处理新方法介绍

通过新的手术方法探讨肝包囊残腔引流闭合的效果，对肝右叶隔顶区包囊合并感染或较严重胆瘘病人于包囊残腔内放置引流管，经过隔下进入腹壁在皮下潜行一段后再进入腹腔，将引流管远端置入ROUX-Y型肠襻内，使残腔内积液经肠腔排出。对8例肝右叶顶部包囊合并较严重感染或巨大残腔合并胆瘘病人进行的手术效果令人满意，该手术与根治性肝包虫囊肿手术相比，具有创伤小、适应征宽的特点，与传统的残腔置管外引流相比具有残腔闭合快、方便病人、减少术后外引流操作管理等优点。     

Cardiac hydatid cyst: report of two cases

Cardiac hydatid cyst is life threatening but rare. It is usually asymptomatic and has potentially lethal complications, so early diagnosis with definitive treatment is life-saving. In the present article, we report two cases. The first is a 30-year-old woman with a primary large multivesicular hydatid cyst in the left ventricle. The second is a 17-year-old woman who had multivisceral involvement with a cardiac hydatid cyst, a congenital cardiac anomaly that was an atrial septal defect complicated by pulmonary hypertension. 2-D echocardiography and magnetic resonance imaging confirmed the diagnosis. Surgical treatment was performed using extracorporeal circulation and adjunctive albendazol therapy.     

Endobronchial findings of hydatid cyst disease: a report of five pediatric cases

Hydatid disease is still an important public health problem throughout the world. Diagnosis of the disease is generally based on clinical and radiological findings. Evaluation of pulmonary disorders by flexible bronchoscopy (FOB) is a rapidly developing facility, but diagnostic and therapeutic FOB for pulmonary hydatid cysts is still controversial. This study examines the findings of endobronchial hydatid cyst disease in five pediatric patients from Turkey, and clinical experience about this subject is reviewed. All our patients presented with unusual symptoms of the disease, and for all of them, diagnosis had been delayed using current diagnostic methods. As a result of our experience, it can be reported that the endobronchial appearance of the hydatid cyst membrane is whitish-yellow, and it is difficult to differentiate it radiologically from some other common causes of endobronchial lesions in childhood, such as endobronchial tuberculosis, foreign body aspirations, mucous plaques, and granulation scars. The findings of these cases show that, hydatid cyst should also be kept in mind in differential diagnosis of endobronchial lesions. In the diagnosis of pulmonary hydatid cyst in children without typical clinical and radiological findings of the disease, FOB examination is a valuable diagnostic procedure.     

肺包虫囊肿破裂误诊38例分析

目的提高对肺包虫囊肿破裂的认识。方法回顾性分析肺包虫囊肿破裂38例误诊的临床资料。结果38例肺包虫囊肿破裂均经手术和病理诊断证实，误诊1—8个月。误诊为肺炎11例，肺脓肿4例，肺结核13例，肺肿瘤6例，胸膜炎2例，液气胸2例。临床表现有突发性呛咳，咳清水样痰液并混有粉皮样薄碎片，或咳脓痰，发热。Casoni试验均阳性。X线检查：右肺包虫囊肿26枚，左肺包虫囊肿12枚。病灶呈模糊大片状阴影18例，类圆形阴影8例，肺包虫囊肿顶见“新月征”4例，“水上浮莲征”4例，液气胸2例，胸腔积液2例。经抗感染等综合治疗后，手术除包虫内囊29例，包虫囊肿肺叶切除9例，38例全部治愈。结论肺包虫囊肿破裂可被误诊为其他疾病，常误诊为肺炎和肺结核。     

Ruptured cerebral hydatid cyst: a case report

In this report we describe a case of cerebral hydatid cyst which ruptured into the subarachnoid space and suggest points which help in the preoperative diagnosis.     

Solitary subcutaneous hydatid cyst: a case report

In the absence of hepatic and pulmonary involvement, hydatid disease of other organs is extremely rare. In this paper, we report on a patient who had a solitary subcutaneous hydatid cyst in the submandibular region.     

Giant hepatic hydatid cyst： A case report

Large type 1 cysts are prone to perforation. Furthermore, insufficient drainage with subsequent abscess is a frequent problem of large cysts. We report here a case of a 19-year old man who was admitted to the hospital with pain in the right upper quadrant and epigastric region. An asymmetrical right upper quadrant enlargement was detected on physical examination. Ultrasonography and computerized tomography revealed a type 1 giant hydatid cyst in the right hepatic lobe, measuring 16 cm in diameter. During operation, partial cystectomy and drainage were done. The large dead space was obliterated by the ‘sandwich’ method. Omentum and gelatin sponges were used to fill the cavity. The postoperative period was uneventful and the patient was discharged on the 5th postoperative day.     

Surgical treatment of hydatid cyst of the lung: review of 30 cases.

Hydatid cyst disease is still a problem in Turkey, especially in the east Anatolian region, as well as in many other places in the world. A retrospective review was made of the surgical treatment of 30 patients with pulmonary hydatid cysts during the last 3 yrs. Nineteen patients were male and 11 female with an average age of 23.5 yrs (range 4-44 yrs). Cystotomy and capitonnage were performed in 28 of the 30 cases (93.4%). The transdiaphragmatic route or simultaneous laparotomy was preferred when the liver was involved. Albendazole was used in four patients with multiple hydatid cyst due to probable recurrence in the postoperative period. Cough and chest pain were the prominent symptoms in the majority of cases. A single lobe was affected in 22 patients. Unilateral multiple foci were present in four patients and bilateral multiple foci in four. Six patients had concomitant liver cysts. Morbidity was low and no mortality was seen. No recurrences were seen on control chest radiographs during the last 2-yr follow-up. In the treatment of hydatid cyst of the lung, conservative surgical methods such as cystotomy and capitonnage still remain the treatment of choice. Medical treatment could be used for prophylactic purposes and in some instances, but the percutaneous aspiration method should not be performed.