| 吴 纲,潘洪帅,赵占学,叶成杰,徐正光,祁君慧,石兵强.四种不同手术方式治疗肝包虫病患者合并术后胆漏的疗效评价[J].,2018,(15):2942-2945 |
| 四种不同手术方式治疗肝包虫病患者合并术后胆漏的疗效评价 |
| Biliary Leakage in Patients with Hepatic Hydatid Disease:Therapeutic Evaluation of Four Different Surgical Treatments Postoperative |
| 投稿时间：2017-10-13 修订日期：2017-11-09 |
| DOI：10.13241/j.cnki.pmb.2018.15.031 |
| 中文关键词: 肝包虫病 内囊摘除术 外囊完整剥除术 外囊次全切除术 肝部分切除术 |
| 英文关键词: Hepatic hydatid disease Endocystectomy Complete cystectomy External capsule for subtotal resection Partial hepate- ctomy |
| 基金项目:青海省卫计委科研指导性项目（2017-wjzdx-21） |
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| 中文摘要: |
| 摘要 目的：探讨四种不同手术方式治疗肝包虫病患者合并术后胆漏的疗效。方法：选取2015年12月至2017年6月间我院收治的肝包虫病患者103例，根据手术方式的不同将患者分为A组（行内囊摘除术，n=26例）、B组（行外囊完整剥除术，n=28例）、C组（行外囊次全切除术，n=25例）、D组（行肝部分切除术，n=24例）。比较各组的手术时间、术中出血量、术后带管时间、住院时间。统计并比较四组患者手术后胆漏的发生率及并发症情况。结果：四组患者的手术时间、术中出血量、术后带管时间、住院时间的整体比较差异有统计学意义（P<0.05）；A组的手术时间、术中出血量明显少于B组、C组、D组，B组和C组的手术时间、术中出血量明显少于D组（P<0.05）；A组的术后带管时间明显多于B组、C组、D组，D组的术后带管时间明显多于B组、C组（P<0.05）；D组的住院时间明显多于A组、B组、C组，A组的住院时间明显多于B组、C组（P<0.05）。A组的术后胆漏的发生率明显高于B组、C组、D组（P<0.05）。四组的膈下感染、胸腔积液发生率比较差异无统计学意义（P>0.05）；A组残腔感染、残腔积液发生率高于B组、C组、D组（P<0.05）；D组的术后肝功能损害的发生率显著高于A组、B组、C组（P<0.05）。结论：外科手术是治疗肝包虫病的主要方式，四种手术方式各有利弊，临床上应结合患者的实际情况选择最合适的手术方式。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the therapeutic evaluation of four different surgical treatments for postoperative biliary leakage in patients with hepatic hydatid disease. Methods: A total of 103 cases of hepatic hydatid disease, who were admitted to Qinghai Provin- cial People's Hospital from December 2015 to June 2017, were selected and divided into group A(undergoing endocystectomy, n=26),group B(undergoing complete cystectomy, n=28), group C(external capsule for subtotal resection, n=25)and group D(undergoing partial hepatectomy, n=24) according to different surgical methods. The operation time, intraoperative blood loss, postoperative tube time and hospitalization time were compared among the four groups. The incidence and complications of bile leakage after operation in the four groups were compared and analyzed. Results: There were significant differences in the operation time, intraoperative blood loss, postoper- ative tube time and hospitalization time among the four groups(P<0.05). The operation time and the amount of bleeding during operation in group A were significantly less than those in group B, C and D; the operation time and the amount of bleeding in group B and group C were significantly less than those in group D (P<0.05). The postoperative tube time of group A was significantly more than that of group B, C and D; the postoperative tube time of group D was significantly more than that of group B and group C (P<0.05). The hospitalization time of group D was significantly more than that of group A, B and C; the hospitalization time of group A was more than that of group B and group C(P<0.05). The incidence of postoperative bile leakage in group A was significantly higher than that in group B, C and D (P<0.05). There were no statistically significant differences in the incidence of diaphragmatic infection and pleural effusion among the four groups(P>0.05). The incidence of residual cavity infection and residual cavity effusion in group A was higher than that in group B, C and D(P<0.05). The incidence of postoperative liver function impairment in group D was significantly higher than that in group A, B and C(P<0.05). Conclusion: Surgical treatment is the main way to treat hepatic hydatid disease, each of the four operation methods has advan- tages and disadvantages, and the most suitable surgical method should be selected according to the actual situation of the patient. |
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