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目的 探讨肝泡状棘球蚴病 ,特别是晚期患者的治疗。方法 回顾性总结肝泡状棘球蚴病患者 89例的手术、手术前后药物治疗 ,或单纯药物治疗的结果。结果 手术治疗 73例 ,手术病死率 3 % (2 / 73)。出院的 71例均获得随访 ,随访 1～ 15年以上。早期患者行根治性肝叶切除术 9例 ,均健在。其中 7年后复发 1例。而行单纯液化腔引流术 4例 ,均死亡。行病变部分切除 5 8例 ,其中同时行胆管置管扩张成形及引流术 18例 ,随访期间死亡 18例。单纯活体组织检查和未手术者 16例 ,其中存活 4例 ,死亡 12例。药物治疗采用甲苯咪唑、丙硫咪唑、吡喹酮等 ,其中以吡喹酮效果较为明显和肯定。结论 根治性肝叶切除术对肝泡状棘棘蚴病是最为理想的治疗方法。部分病变切除 ,解除胆管和血管压迫 ,结合手术前后有效的药物治疗对晚期泡状棘球蚴病是有效、可行的治疗措施 ,有希望在多数肝泡状棘球蚴病患者取得较好的治疗效果。
Objective To investigate the treatment of hepatic alveolar hydatid disease, especially in advanced patients. Methods A retrospective review of 89 patients with hepatocellular alveolar echinococcosis surgery, preoperative and postoperative drug therapy, or simple drug treatment results. Results Surgical treatment of 73 cases, surgical mortality was 3% (2/73). All of the 71 discharged patients were followed up for more than 1 to 15 years. In the early patients, radical hepatectomy was performed in 9 patients. One case of recurrent after 7 years. The line of simple liquefied drainage in 4 cases, all died. Fifty-eight cases underwent partial resection of the lesion. Among them, 18 cases underwent biliary duct dilatation and drainage and drainage at the same time, 18 cases died during follow-up. There were 16 cases of simple biopsy and no surgery, including 4 cases of survival and 12 cases of death. Drug treatment with mebendazole, albendazole, praziquantel, etc., of which praziquantel more obvious and positive. Conclusions Radical hepatectomy is the most ideal treatment for hepatic alveolar echinococcosis. Part of the lesion resection, the removal of bile duct and vascular compression, combined with effective drug treatment before and after surgery for advanced alveolar hydatid disease is an effective and feasible treatment, there is hope that in most patients with hepatic alveolar hydatidosis better treatment effect.