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感染性肝包虫病:一组连续患者的外科治疗结果

Infected Hepatic Echinococcosis: Results of Surgical Treatment of a Consecutive Series of Patients.

作者信息

Manterola Carlos, Urrutia Sebastián

机构信息

1 Department of Surgery and Traumatology, Universidad de La Frontera , Temuco, Chile .

2 Centre of Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera , Temuco, Chile .

出版信息

Surg Infect (Larchmt). 2015 Oct;16(5):553-7. doi: 10.1089/sur.2014.054. Epub 2015 Jun 30.

Abstract

BACKGROUND

One of the progressive complications of hepatic echinococcosis (HE) is cyst infection and subsequent liver abscess of a hepatic formation (LAHO). To date, this entity has not been studied or reported on extensively. Traditionally, the issue has been addressed with cystectomy and drainage, but this is associated with unsatisfactory outcomes. The aim of this study was to describe the results of surgical treatment in a group of patients with LAHO in terms of post-operative morbidity (POM).

METHODS

We describe a case series of 64 consecutive patients with LAHO treated at two medical centers in Temuco, Chile. General and liver laboratory parameters were determined, thoracic radiographs, and abdominal ultrasound and computed tomography scans were performed. Study variables were POM, hospital stay, mortality rate, and recurrence. The minimum follow-up was three months, and clinical checkups were undertaken at months 1, 6, 12, 24, 36, 48, and 60. Descriptive statistics were applied.

RESULTS

Sixty-four patients were treated with a median age and cyst diameter of 51 years and 16 cm, respectively. Of the series, 57.8% were female. The median hospital stay was 8 days. General POM and mortality rates were 23.4% and 3.1%, respectively. With a median follow-up of 67 months, non-hydatid recurrences were observed.

CONCLUSION

The POM of LAHO is high, and the mortality rate is significant if we consider it a clinical entity within the context of a benign disease.

摘要

背景

肝包虫病(HE)的渐进性并发症之一是囊肿感染及随后形成的肝脓肿(LAHO)。迄今为止,对该病症尚未进行广泛研究或报道。传统上,该问题通过囊肿切除术和引流术来解决,但这会带来不尽人意的结果。本研究的目的是从术后发病率(POM)方面描述一组LAHO患者的手术治疗结果。

方法

我们描述了在智利特木科的两个医疗中心连续治疗的64例LAHO患者的病例系列。测定了一般和肝脏实验室参数,进行了胸部X光片、腹部超声和计算机断层扫描。研究变量包括POM、住院时间、死亡率和复发情况。最短随访时间为三个月,在第1、6、12、24、36、48和60个月进行临床检查。应用描述性统计方法。

结果

64例患者接受了治疗,中位年龄和囊肿直径分别为51岁和16厘米。该系列中,57.8%为女性。中位住院时间为8天。总体POM和死亡率分别为23.4%和3.1%。中位随访67个月时,观察到非包虫复发情况。

结论

如果将LAHO视为良性疾病背景下的一种临床实体,其POM较高且死亡率显著。

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