肝包虫病的外科治疗

目的　总结肝包虫病 1740例手术治疗的经验 ,特别是对肝包虫性急腹症及其并发症的治疗方法。方法　对 196 0～ 1997年 1740例肝包虫病例资料进行回顾分析。结果　本组主要并发症中 ,感染为 116 9例次 ,内瘘 388例次 ,破裂 2 15例次。术后并发症为胆汁瘘、囊内感染、外囊残腔闭合不全等。本组手术治愈率为 99 4% ,死亡 9例 (0 6 % )。结论　肝包虫对人体损害主要为肝包虫并发症。肝包虫及其并发症的治疗以外科手术为主 ,特别是对肝包虫破裂所致的急腹症应立即手术 ,清除包虫内容物 ,并即时抗休克、抗感染、抗过敏治疗。术后即时给予抗包虫药物治疗。

Surgical treatment of hepatic echinococcosis

Objective To summarize the experiences in surgical treatment of 1?740 patients with hepatic echinicoccosis(HE), especially the choice of surgical procedures for patients with acute abdomen and complications caused by HE. Methods A retrospective study was made on the clinical data of 1?740 patients with HE from 1960 to 1997. Results In this series, the complications included infection(61%), rupture(11.3%), inner fistula(21.3%). Postoperative complications included biliary fistula, inner cyst infection and insufficient closing of the remaining cavity. The curative rate by operation in this series was up to 99.4%, while 9 cases(0.6%) died. Conclusions The major damage of HE to human body is its complications. The surgical treatment is the main mothod for management of HE and its complications. An emergency operation is particularly recommended for acute abdomen caused by rupture of echinococcous cysts. At the same time, corresponding treatment of shock, anaphylaxis are needed and anti echinococcous drug therapy should be given postoperatively.