复杂性肝囊性包虫病的术式选择探讨-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 复杂性肝囊性包虫病术式选择探讨 研究生：孟瑞敏 导师：赵晋明教授 摘 要 目的：通过评价复杂性肝囊性包虫病不同手术方式的临床疗效，探讨复杂性肝 囊性包虫病的术式选择。方法：采用回顾性方法总结分析 123 例复杂性肝囊性包虫 病不同手术方式术后的平均住院日、术中出血量、术后残腔并发症(胆漏、感染、积 液)、置管时间及手术死亡率。其中 31 例患者(25.20%)施行肝包虫内囊摘除术作为 A 组；29 例患者(23.58%)施行肝包虫外囊完整剥除术作为 B 组，56 例患者(45.53%)行 肝包虫内囊摘除+外囊部分切除术作为 C 组；7 例患者(5.69%)行肝叶部分切除术作为 D 组。结果：治愈 123 例，死亡 0 例。内囊切除术组（A 组）的带管天数及残腔并 发症发生率明显高于其它 3 组；肝叶部分切除术组（D 组）的住院天数明显高于其 它 3 组；内囊切除术组（A 组）的术中出血量明显低于其它 3 组，肝叶部分切除术 组（D 组）术中出血量明显高于其它 3 组。结论：内囊摘除术治疗复杂性肝包虫病 术后残腔并发症发生率高，带管时间长，已逐渐被内囊摘除+外囊部分切除术所取代。 外囊完整剥除术对包虫位置、与周围关系及手术技巧要求较高，使其在临床应用受 到限制。外囊部分切除术是在因复杂性肝囊性包虫与周围粘连严重等原因不能行外 囊完整剥除术时选用的术式，已成为治疗复杂性肝囊性包虫病的主要手术方式。肝 叶部分切除术因其在术中出血量大，对肝脏损害大，现一般不常用。 关键词：复杂性肝囊性包虫；手术；术式选择 新疆医科大学医学硕士学位论文 Selection of surgical method about complex liver cystic echinococcosis Postgraduate: Meng Ruimin Supervisor: Professor Zhao Jinming Abstract Objective: Evaluation the clinical effects of different surgical for complex liver cystic echinococcosis. Explore the surgical option of liver cystic echinococcosis. Method: Retrospective analysis of 123 cases of complex liver cystic hydatid disease in different ways of surgery and after surgery the average length of stay, surgical bleeding, postoperative residual cavity complications (bile leakage, infection, effusion), catheterization time and mortality. 31 cases of patients (25.20%) for the choice of internal capsule extraction as Group A; 29 patients (23.58%) for the choice of integrity of hydatid cyst removed as group B, 56 patients (45.53%) for the choice of outside capsule partial laryngectomy as the C group and 7 patients (5.69%) for the choice of hepatic lobectomy as group D. Result: 123 patients were cured, no patient dead.Among the internal capsule resection group (group A) ,the number of days with tube and residual cavity complication rate was significantly higher than other 3 groups; In hepatic lobectomy group ( group D) ,the length of hospital stay was significantly higher than other 3 groups; In internal capsule resection group (group