小儿肝泡状棘球蚴病的治疗(附36例报告)

Treatment of hepatic alveolar echinococcosis in children:a report of 36 cases

目的总结小儿肝泡状棘球蚴病的治疗效果。方法对１９７８年１月至１９９７年１１月手术和药物治疗的３６例小儿肝泡状棘球蚴病做回顾性总结。结果手术组１７例（其中行病灶根治性切除５例、病灶部分切除７例、取活体组织检查５例），药物治疗组１９例，口服丙硫咪唑１０ｍｇ·ｋｇ－１·ｄ－１１～３年。手术组７年存活６例（３５％），其中行病灶根治性切除的５例全部存活，病灶部分切除者仅存活１例；药物治疗组存活６例（３２％），但病情均加重。本组总存活率为３３％（１２／３６）。结论根治性切除为本病最佳治疗方法。

Objective To evaluate the therapeutic effects of surgery and medication on hepatic alveolar echinococcusis (HAE) in children.Methods A total of 36 HAE cases admitted from Jan. 1978 to Dec. 1997 were treated in our hospital.25 of them were male, and 11 were female with mean age of 12 9.Seventeen cases underwent surgery including radical resection in 5 cases,partial resection of the foci in 7 cases, and biopsy only in 5 cases.The remaining 19 cases were treated with albendazole 10 mg·kg -1 ·d -1 for 1～ 3 years. The follow up was carried out by physical examination, B type ultrasonic examination and test for hepatic functions.Results Six cases undergoing surgery were still alive at follow up of 7 years,among them 5 cases that underwent radical resection were all alive,whereas only one that received partial resection was alive.6 cases in medicinal group were alive with a survival rate of 32%,and with deterioration of their illness.The total survival rate in this group was 33 3 % (12/36).Conclusions The radical operation is the best therapeutic method for HAE.