肝包虫病外科治疗经验

Experience in the surgical treatment of hepatic hydati-dosis

我院自１９５４年至１９９０年共收治包虫病１２９０例，在经手术治疗的９０７例中，男４８４例（５３．３％），女４２３例（４６．７％）。年龄５～６８岁。单房肝包虫者占５４％，多房者占２１．２％。肝包虫因各种原因发生破裂者１１７例（１２．９％）。文中对单纯肝包虫和复杂性肝包虫囊肿的手术原则、步骤作了扼要的描述。作者强调不向包虫囊和其残留的外囊内注入强烈刺激性药物；主张在术中输液同时加入糖皮质激素；术前与术后常规给阿苯达唑或甲苯达唑；对复杂病例全身或局部使用抗生素。全组死亡５例。

AbstractOf 1290 cases ofhydatidosis hospitalized,907(70.3%)cases of hepatichydatid cyst(HHC)weretreated surgically ( 1954～1990).Of the 907 cases,484 (53.3%)were males and 423(46.7%)fernales.Hepatic hydatid cysts were single in 54%, multiple in21.2%and complicated with hydatid cysts of other or-gans in 24.8%。67.5%of the cysts were in the rightlobe of the liver,15.6%in the left lobe,16.9%inboth lobes; 79.0%were situated in the right lowerpart of the liver,21.0%on the dome of the liver.Rupture of the cysts into biliary system , peritonealcavity , the thorax(pulmonarv-bronchial tree)and thepericardial sac were 35 (30%),50(42.6%),31(26.5%)and 1 case (0.9%)respectively. There were5 deaths.Our experiences include:(1) routine intravenousdrip of corticosteriods to alleviate the possible occur-rence of allergic reaction during the operation and post-operative hyperpyrexia。(2)mebendazole or albenda-zole (ABZ)20mglkg/dfor one week before operationand1～2courses(1 course =30days)after operation todestroy the protoscoleces left in the body during opera-tion,(3) antibiotics administration in complicated cas-es. (4)closure of intrahepatic biliary fistula.