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肝脏包虫囊肿的临床特征与管理:来自尼泊尔一家三级医疗中心的研究

Clinical Characteristics and Management of the Hydatid Cyst of the Liver: A Study from a Tertiary Care Center in Nepal.

作者信息

Joshi Utsav, Subedi Roshan, Jayswal Amar, Agrawal Vishakha

机构信息

Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu 44600, Nepal.

出版信息

J Parasitol Res. 2020 Sep 9;2020:8867744. doi: 10.1155/2020/8867744. eCollection 2020.

Abstract

A hydatid cyst of the liver is a significant yet neglected public health problem in Nepal. The present study was carried out to evaluate the demographic characteristics, clinical presentations, and management of the patients of the hydatid cyst of the liver in the setting of a developing country. It was a retrospective, descriptive analysis of 53 patients admitted in the department of surgery with the diagnosis of hydatid cyst of the liver based on clinical manifestations, imaging studies, or serology between 2016 and 2019. The median age of the patients was 36 years, with the age group of 25-45 years being the most commonly affected (23, 43.4%). 58.5% of the patients were female. Abdominal pain (49, 92.5%) and a palpable liver (17, 32.1%) were the most common complaint and physical finding in our study population, respectively. Abdominal ultrasonography and computed tomography scan were the major imaging studies used to establish a diagnosis. A unilocular and anechoic cystic lesion was the most frequent imaging finding. The right lobe of the liver harbored the cysts in the maximum number of patients. Surgery was the preferred modality of treatment (23, 43.4%), with pericystectomy being the most common form of surgical intervention. The hydatid cyst of the liver is a common cause of morbidity in Nepal. Clinical evaluation supplemented by imaging studies is required for diagnosis, and surgery remains the treatment of choice in most cases. To explain the epidemiological pattern of the disease, multicentric studies involving a larger sample of patients should be conducted.

摘要

肝包虫囊肿在尼泊尔是一个严重但被忽视的公共卫生问题。本研究旨在评估在一个发展中国家背景下,肝包虫囊肿患者的人口统计学特征、临床表现及治疗情况。这是一项回顾性描述性分析,研究对象为2016年至2019年间因临床表现、影像学检查或血清学检查诊断为肝包虫囊肿而入住外科的53例患者。患者的中位年龄为36岁,25 - 45岁年龄组受影响最为常见(23例,占43.4%)。58.5%的患者为女性。腹痛(49例,占92.5%)和可触及肝脏(17例,占32.1%)分别是我们研究人群中最常见的症状和体征。腹部超声和计算机断层扫描是用于确诊的主要影像学检查。单房无回声囊性病变是最常见的影像学表现。肝右叶囊肿患者数量最多。手术是首选的治疗方式(23例,占43.4%),囊肿切除术是最常见的手术干预形式。肝包虫囊肿是尼泊尔发病的常见原因。诊断需要结合影像学检查进行临床评估,在大多数情况下手术仍是首选治疗方法。为解释该疾病的流行病学模式,应开展涉及更多患者样本的多中心研究。

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