小儿肝细粒棘球蚴病术后并发症相关因素分析

Related factor of postoperative complications of hepatic cystic echinococcosis in children

目的对小儿细粒棘球蚴病术后并发症与临床资料进行相关性分析，寻找发生并发症的危险因素。方法回顾性分析新疆医科大学第一附属医院2002年1月至2015年1月期间收治的191例14岁以下（包含14岁）肝囊性棘球蚴病患儿的临床资料，分别对患儿性别、体征、有无胆漏、肝包虫囊肿个数、肝包虫囊肿破裂、有无合并其他脏器包虫、包虫大小、术式与术后并发症相关性进行单因素及多因素二分类Logistic回归分析。结果行姑息性手术（改良内囊摘除术与外囊次全切除术）152例，行根治性手术（外囊完整剥离术式与肝切除术式）39例。术后共有26例患儿发生并发症，单因素统计分析显示术后发生并发症与腹痛、包虫胆漏、包虫囊肿破裂相关（P〈0.05）；其他指标差异均无统计学意义。进行单因素分析时未控制其他因素干扰，将P〈0.1的变量纳入到多因素回归模型，进行二分类Logistic回归，结果腹痛、包虫胆漏、包虫囊肿破裂变量有统计学意义，并且是危险因素。结论性别、体征、肝包虫囊肿个数、有无合并其他脏器包虫、包虫大小、术式不是影响术后并发症发生的因素，腹痛、术中包虫囊肿合并胆漏和包虫术前破裂的患儿术后并发症的发生率显著高于其他患儿。

ObjectiveTo summarize the clinical features of hepatic cystic echinococcosis （HCE） in children and analyze the relevant factors of postoperative complications.MethodsA total of 191 HCE children undergoing surgical treatment between January 2002 to January 2015 were retrospectively evaluated. Data collection included symptoms, characteristics of cyst （location, size, quantity）, surgical options, hospitalization duration and postoperation complications. And univariate and multivariate analyses were performed among P〈0.1 variables for determining the independent risk factors for postoperative complications for HCE.ResultsA total of 152 cases underwent partial cystectomy plus external drainage and subtotal pericystectomy while another 39 cases had radical operations of pericystectomy and segmentectomy. Postoperative complications of abdominal pain, cystobiliary communication and ruptured cyst occurred in 26 cases （P〈0.05）.ConclusionsAbdominal pain, cystobiliary communication and ruptured cyst are independent risk factors for postoperative complications.