肝包虫病并发胆道感染的诊断和治疗(附36例报告)

作者报道了肝包虫病并发胆道感染36例。肝细粒棘球蚴压迫或破入胆道和肝泡状棘球蚴侵蚀胆道是导致胆道感染的主要原因,临床上具有一般胆道感染及肝包虫病的特点,B超、CT及PTC能协助诊断。治疗应尽早行胆道及包虫腔引流;泡状棘球蚴所致胆道感染则需通过包虫累及胆道置U管引流。手术前后应给予氨基甙类抗生素和甲硝唑。

The Diagnosis and Treatment of Hepatic Echinococcosis Complicated with Infection of the Biliary Tract

36 patients with hepatic echinococcosis complicated with infection of the biliary tract were treated in our hospital from December of 1982 to December of 1992. Male 14, female 22, age were between 13 to 55 years, all came from the pastoral area. The diagnosis depended on the symptoms of cholangitis and hepatic hydatidosis, the signs with hepatomegaly, tenderness of right upper abdomen, the labo- ratory findings with leukocytosis and positive reaction of Casoni test, B-ultrasound, PTC and ERCP were helpful for diagnosis. It is necessary to perform the drainage of the cystic cavities and biliary tract on the patients with the infection, after cleaning away the daughter cysts and debris of the endocysts from the cavities and biliary tract. The biliary tract invaded by the alveolar cyst should be put with a U-tube through the bile ducts for bile drainage. Besides, the effective antibiotics should be administrated.