肝泡球蚴病41例治疗分析

Treatment of Liver Alveolar Echinococcosis—An Analysis of 41 Cases

目的:探讨肝泡球蚴病手术治疗方式和疗效。方法:对我院2008年5月—2011年5月收治的41例肝泡球蚴病患者不同治疗方式进行分析、总结。结果:36例行手术治疗。术中失血死亡1例,术后3天肝衰死亡1例。根治性肝叶切除10例中1例死于门静脉栓塞,余均健在。姑息性切除22例中4例1年内死于术后并发症(胆漏、残端感染、肝肾综合征、上消化道大出血),5例在4年内因肝功衰竭或转移死亡。自体肝移植4例中3例存活。结论:根治性手术仍是治疗肝泡球蚴病的首选方法。姑息性手术多用于解决梗阻性黄疸或并发症。自体原位肝移植技术,在肝源紧张的情况下,可为根治性切除肝泡球蚴病开辟一条全新的途径。

Objective： To discuss the effective surgery therapy for liver alveolar echinococcosis（LAE）.Methods：41 cases of LAE were collected in this report.We compared the difference of efficiency among 36 cases of LAE,who underwent the surgical treatment from May 2008 through May 2011 in our hospital.Results：In 36 patients underwent operation,one died from hemorrhage during operation,anther one died from functional failure of liver after 3 days operation,one of 10 cases of radical resection died from portal vein embolization.4 of 22 cases of palliative resection died from postoperative complication in one year,and 5 cases died from failure of liver function in four years.3 of 4 cases of self-transplantation were surviving.Conclusions：The LAE would be firstly treated with radical resection;the palliative therapy used to treat the obstructive jaundice or complications;and Self-transplantation could be a new way for treatment of LAE because lack of donor liver.