肝包虫性急腹症的诊断与治疗(附297例报告)

Diagnosis and Treatment of Acute Abdominal Pain Caused by Hepatic Hydatid (Reports of 297 Cases)

目的总结肝包虫性急腹症的诊断与治疗经验。方法对297例肝包虫性急腹症的手术前诊断、手术方法及术后疗效进行回顾性分析。结果手术297例中，治愈285例，治愈率为95．96％；死亡12例，死亡率为4．04％，其中6例因囊肿破入腹腔致弥漫性胆汁性腹膜炎及过敏性休克死亡，2例因包虫种植，多次手术后死于营养不良，4例为巨大肝包虫，内囊液为7000～12000ml，术后继发囊内感染而死于肝功能衰竭。结论肝包虫性急腹症应以外科急诊手术治疗为主，同时应积极给予抗休克、抗感染及抗过敏治疗。

Objective To summarize the experience of diagnosis and treatment of acute abdominal pain caused by hepatic hydatid. Methods The preoperative diagnosis, the surgical methods and the curative effect after operation of 297 patients with acute abdominal pain caused by hepatic hydatid who were treated in our hospital from 1960 to 2004 were analyzed. Results The healing rate was 95.96% （285/297 cases）, and the death rate was 4.04% （12 /297 cases）. Six out of 12 cases of death were caused by diffusive biliary peritonitis and allergic shock attributable to the rapture of hydatid into abdominal cavity. Two patients died of malnutrition caused by the spreading of Echinococcus and the correspondingly repeated operations. Another 4 patients with giant hydatid containing 7 000- 12 000 ml fluid, died of hepatic insufficiency caused by the postoperative infection in the cyst. Conclusion The acute abdominal pain caused by hepatic hydatid should be treated mainly through emergency operation and the necessary antianaphylaxis, anti-infection and antishock therapies should also be used at the same time.