泡型包虫病手术治疗的现状与进展

Current status and progress of surgical treatment for alveolar echinococcosis

泡型包虫病的手术治疗方式包括根治性切除(根治性肝切除术)、姑息性切除(姑息性肝切除术)、自体及异体肝移植术。根治性肝切除术是泡型包虫病最为有效的治疗方法,但因泡型包虫病患者早期无明显症状,大部分患者就诊时已处于中晚期,失去了根治性切除机会。姑息性肝切除术治疗泡型包虫病,其预后与残余病灶体积有关;切除90%以上病灶,并持续服用阿苯达唑者疗效几乎与根治性切除相当。对于已无法切除且无脑转移的泡型包虫病患者,可行同种异体或自体肝移植术,并于术后持续服用阿苯达唑治疗。本文对泡型包虫病手术治疗的现状与进展进行综述,以期为泡型包虫病的正确术式选择提供参考依据。

The surgical treatment methods for alveolar echinococcosis include radical resection(radical hepatectomy),palliative resection(palliative hepatectomy),and autologous and allogeneic liver transplantation.Radical hepatectomy is the most effective treatment method for alveolar echinococcosis.However,due to the lack of obvious symptoms in the early stages of alveolar echinococcosis,most patients are already in the middle and late stages of treatment,losing the opportunity for radical resection.Palliative hepatectomy for the treatment of alveolar echinococcosis is related to the prognosis and residual lesion volume,the efficacy of removing more than 90%of the lesion and continuously taking albendazole is almost equivalent to that of radical resection.For patients with alveolar echinococcosis who are no longer resectable and have no brain metastasis,allogeneic or autologous liver transplantation is feasible,and continuous treatment with albendazole is recommended after surgery.This article reviews the current status and progress of surgical treatment for alveolar echinococcosis,in order to provide reference for the correct surgical selection of alveolar echinococcosis.