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采用Örmeci技术经皮治疗脾脏包虫病:26年单中心经验

Percutaneous treatment with the Örmeci technique for hydatid disease located in the spleen: Single center experience for twenty six years.

作者信息

Örmeci Necati, Kalkan Çağdaş, Karakaya Fatih, Erden Ayşe, Köse Kenan Serdal, Tüzün Ali Emrehan, Deda Xheni

机构信息

Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.

Department of Radiology, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Turk J Gastroenterol. 2018 Sep;29(5):566-573. doi: 10.5152/tjg.2018.17890.

Abstract

BACKGROUND/AIMS: Hydatid disease remains an important global socioeconomic health problem, particularly in the endemic areas. Although half of the patients show no symptoms, hydatid cysts should be treated because of their fatal complications. The aim of this study is to present the long-term results of percutaneous treatment of hydatid disease using the Örmeci technique.

MATERIALS AND METHODS

Forty-nine patients with 54 cystic lesions were diagnosed with hydatid disease. Twenty-seven of the 54 hydatid cysts located in the spleen were punctured with a 22-gauge Chiba needle through the parenchyma of the spleen under sonographic guidance as a one-step procedure. For every 1 cm of the long diameter of the cyst lesion, 3 cc of fluid from the cysts was aspirated. For each centimeter of the long diameter, 2 cc of pure alcohol (96%) and 1 cc of polidocanol (1%) were injected into the cysts. Five out of 27 patients did not participate in the follow-up.

RESULTS

The 22 patients who were treated using the percutaneous Örmeci technique were followed up for a mean±SD (median) of 50.32±65.30 (26.00) months (minimum 4 and maximum 298 months). All patients except one were successfully treated. No deaths or major complications were noted. Seven patients experienced minor complications.

CONCLUSION

Percutaneous treatment with the Örmeci technique is a safe, effective, cheap, and reliable method that does not interfere with splenic functions, and this outpatient procedure should be the method of choice for a surgery alternative.

摘要

背景/目的:包虫病仍然是一个重要的全球社会经济健康问题,尤其是在流行地区。尽管一半的患者没有症状,但由于包虫囊肿会引发致命并发症,仍需进行治疗。本研究的目的是介绍使用Örmeci技术经皮治疗包虫病的长期效果。

材料与方法

49例患者共54个囊性病变被诊断为包虫病。在超声引导下,通过脾脏实质用22号千叶针穿刺54个位于脾脏的包虫囊肿中的27个,作为一步操作。对于囊肿病变长径每1厘米,从囊肿中抽吸3毫升液体。对于长径每厘米,向囊肿内注入2毫升纯酒精(96%)和1毫升聚多卡醇(1%)。27例患者中有5例未参与随访。

结果

采用经皮Örmeci技术治疗的22例患者的随访时间平均±标准差(中位数)为50.32±65.30(26.00)个月(最短4个月,最长298个月)。除1例患者外,所有患者均成功治愈。未观察到死亡或严重并发症。7例患者出现轻微并发症。

结论

Örmeci技术经皮治疗是一种安全、有效、廉价且可靠的方法,不影响脾脏功能,这种门诊手术应作为手术替代方案的首选方法。

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