Minaev S V, Gerasimenko I N, Bykov N I, Timofeev S V
Vestn Khir Im I I Grek. 2013;172(1):71-4.
Sixty children (age 3-15 years) with hydatid disease of the liver were treated. The patients were divided into 2 equal groups (control and main groups).The hydatid disease of the liver was revealed in 22 (33.6%) patients, combined hydatid disease of the liver and lung were noted in 38 (66.4%) patients. The "capitonnage" of the residual cavity was applied in the control group and omentoplasty--in the main group. Chemotherapy with Nemazol (dose 10-15 mg/kg/day) was carried out. In order to reduce the negative influence of Nemazol on patients and to accelerate reparation processes of liver parenchyma Vobenzyme (2-3 pills/3 times/day) was applied. The number of complications was 23.2 % in the control group. The adhesive bowel obstruction was noted in 6.6% of patients, bleeding and jaundice in 3.3%, the residual cavity suppuration in 10%. Complications were registered in the main group in 6.6% of children (the adhesive bowel obstruction in 3.3%, preservation of the residual cavity after a year in 3.3%). The number of relapses in the control group was 6 (12%), there were no relapses in the main group. Thus the procedure of preoperative and postoperative chemotherapy allowed avoidance of the development of relapses of hydatid disease of the liver. Omentoplasty is the most rational method of treatment of residual cavity in surgery of hydatid disease of the liver in children.
对60例（年龄3 - 15岁）肝包虫病患儿进行了治疗。将患者分为两组（对照组和主要治疗组），每组人数相等。22例（33.6%）患者表现为单纯肝包虫病，38例（66.4%）患者为肝肺联合包虫病。对照组采用残腔“缝合术”，主要治疗组采用大网膜成形术。采用内硫咪唑（剂量10 - 15mg/kg/天）进行化疗。为减少内硫咪唑对患者的负面影响并加速肝实质的修复过程，应用了维酶素（2 - 3片/每日3次）。对照组并发症发生率为23.2%。6.6%的患者出现粘连性肠梗阻，3.3%出现出血和黄疸，10%出现残腔化脓。主要治疗组6.6%的儿童出现并发症（3.3%为粘连性肠梗阻，3.3%为一年后残腔仍存在）。对照组复发6例（12%），主要治疗组无复发。因此，术前和术后化疗程序可避免肝包虫病复发。大网膜成形术是儿童肝包虫病手术中治疗残腔最合理的方法。
