3种术式对肝包虫疗效的临床效果对比与分析

Compare and Analyze Clinical Effects of 3 Kinds of Surgical Procedures on Hepatic Hydatid

目的对比3种术式对肝包虫疗效的临床效果.方法收集2002年2月—2012年1月在重庆市开县中医院普外科收纳的肝包虫病患者98例,随机分为3组,1组:32例内囊摘除术;2组:35例实施包虫外囊完整剥除术;3组:31例实施外囊次全切除术.结果术后3组患者无手术死亡.与肝包虫内囊摘除术组比,外囊完整剥除术组和外囊次全切除术组患者的术中出血量、手术时间、住院时间、引流时间、原位复发率和并发症发生情况差异显著,具有统计学意义(P<0.05);与外囊完整剥除术组比,外囊次全切除术组的手术时间较短(P<0.05).结论肝包虫内囊摘除术术后并发症发生较高;外囊完整剥除术手术难度大,风险高,不宜普及;外囊次全切除术在降低手术风险的同时,执行技术规范操作可同样达到根治肝包虫,并不易出现包虫复发、残腔积液、感染等并发症.

Objective To compare the clinical effects of 3 kinds of surgical procedures on hepatic hydatid.Method 98 cases of hepatic hydatid hospitalized from February 2002 to June 2011 in the Department of General Surgery in our hospital were collected and randomly divided into 3 groups:1st group:32 cases with underwent cystectomy;2nd group:35 cases with underwent pericystectomy;3nd group:31 cases with underwent subtotal pericystectomy.Results There were no died patients in 3 groups after the operation.Compared with those in the cystectomy group,the intraoperative blood loss,operative time,hospital stay,drainage time,recurrence rate and occurrence of complications in the pericystectomy and the subtotal pericystectomyg groups were significantly different(P<0.05).Compared with that in the pericystectomy group,the operation time was shorter in subtotal pericystectomyg group(P<0.05).Conclusion The incidence of postoperative complications should be higher in the cystectomy;Pericystectomy might be in high risk and difficult to be popularized;The performance of subtotal pericystectomy could not only reduce the risk of surgery,also eradicate the hepatic hydatid,and prevent the recurrence of hepatic hydatid,the effusion in the residual cavity and the infection if the technical regulation was implemented strictly during the operation.