复发性肝包虫病的诊治

THE DIAGNOSIS AND TREATMENT OF RECURRENT HEPATIC HYDATLD

目的 探讨肝包虫病局部复发的病因、诊断、治疗方法。方法 对 10 5例复发性肝包虫病患者进行了回顾性分析。结果 肝包虫病复发的原因主为囊液外漏 ,或术中遗留有含子孙囊壁生发层的包虫囊壁。术后血清包虫相关抗体滴度下降缓慢。结论 复发性肝包虫病患者的诊断应主要依靠 B超及 CT,而不应依靠血清学检查。手术前后辅助性应用阿苯哒唑 ,采用囊肿完整切除及肝叶切除术 ,术中严密保护周围组织 ,是减少复发的主要措施。

Objective To discuss the etiology,diagnosis,treatment of local recurrent hepatic hydatid.Methods 105 patients suffered from recurrent hepatic hydatid were retrospectively reviewed.Result Local recurrences were frequently due to spillage of liver parasite or leaving a residual cyst wall containing germinal epithelium,daughter cysts,or protoscolices during surgery.Blood titers decreased slowly over months to years even with complete removal of disease.Conclusion The diagnosis mainly depended on ultrasonograph or computed tomography.The treatment of local recurrent disease should include administration of albendazole followed by the appropriate application of interventional ultrasound-guided aspiration or operation.It is very important to be meticulous when carrying out conservative surgery to avoid intraperitoneal spillage.Complete cystopericystectomy or liver resection should be adopted as soon as possible.