小儿肝囊型包虫病552例的诊断和外科治疗

Diagnosis and surgical treatment for the hepatic cystic echinococcoosis in 552 children

目的总结小儿肝囊型包虫病的诊断和治疗经验。方法回顾性分析1957～1997年间外科手术台疗的552例小儿肝囊型包虫病的临床资料。结果儿童期感染较多,发病率与年龄成正比。儿童肝脏血运丰富是小儿肝包虫囊肿生长速度快、钙化少和术后残腔迅速缩小或消失的原因;66%的小儿包虫为多发单囊型,多子囊型仅7.4%;并发症主要发生于年长儿;儿童免疫应答力弱,其血清反应比成年人弱,B 型超声检查310例,诊断符合率100%。结论影像学和血清学检查有较大诊断价值,内囊摘除术和外囊缝合术是治疗小儿肝包虫病的主要手术方法。

Objetive To investigate the diagnosis and surgical treatment of cystic echinococcsis in children.Methods Retrospective analysis was made on 552 child patients with cystic echinococcosis in the liver and abdomen ad- mitted between 1957～1997 undergoing surgical treatment.Results Infection was common in childhood and the mobidity increased with the patient age.The cyst usually grows fast,the calcification was much less common and the postoperative residual cavity rapidly shrank or disappeared because child's liver enjoys bumper blood supply.In 66% of the cases,the lesion was multiple cysts or multiple organ cysts,and the multiple daughter cysts were encounted in only 7.6% of all cases.The postoperative complications mainly developed in over 6- year age group.For serodiagnosis of echinococcosis,in general,the positive reaction in children was weaker than that in adult.Endocystectomy with suture of exocystic wall was majour surgical management for the child cystic echinococcosis(82%).Conclussion An early diagnosis can be obtained by analysing the clinical fea- ture,ultrosonic examination and serodiagnosis.Endocystectomy was relatively less traumatic,simple procedure with quick recovery.