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[肝肺联合棘球蚴病的手术策略]

[Surgical tactics in associated echinococcosis of the liver and lung].

作者信息

Pomelov V S, Karimov Sh I, Nishanov Kh T

出版信息

Khirurgiia (Mosk). 1991 Nov(11):69-74.

PMID:1779557
Abstract

Over 10 years operations were conducted in 28 patients with hydatid disease with concurrent involvement of the liver and lungs, which accounted for 5.76% of all patients with hydatid disease of the thoracic and abdominal organs. The following variants were encountered: uncomplicated echinococcosis of the right lung and right hepatic lobe (13 patients); uncomplicated echinococcosis of the left lung and liver (3); suppurative hydatid cyst of the liver with rupture into the pleural cavity and the development of pyothorax (9); rupture of a hepatic hydatid cyst into the bronchial tree of the right lung with the development of a cysto-bronchial fistula (3 patients). In the group of 28 patients with concurrent involvement of the liver and lung 18 were operated on through a thoraco-phreno-laparotomic approach, 9 through a transpleural approach, and one patient underwent a two-stage operation. The success of the treatment is determined by early recognition of the concurrent echinococcosis and the choice of the optimal surgical tactics. One-stage echinococcotomy from the liver and lung is the operation of choice in concurrent affection of the liver and right lung.

摘要

对28例肝肺同时受累的包虫病患者进行了长达10余年的手术治疗,占胸腹部器官包虫病患者总数的5.76%。出现了以下几种情况:右肺和右肝叶单纯性棘球蚴病(13例);左肺和肝脏单纯性棘球蚴病(3例);肝脓肿性包虫囊肿破裂进入胸腔并发脓胸(9例);肝包虫囊肿破裂进入右肺支气管树并发囊肿支气管瘘(3例)。在这28例肝肺同时受累的患者中,18例通过胸腹联合切口手术,9例通过经胸手术,1例患者接受了两期手术。治疗的成功取决于对同时存在的棘球蚴病的早期识别以及最佳手术策略的选择。肝肺一期棘球蚴切除术是肝和右肺同时受累时的首选手术方式。

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