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肝包虫病的双腔管(穿刺、抽吸、注药、再抽吸)疗法近期疗效观察。

RECENT TREATMENT RESULTS OF LIVER ECHINOCOCCOSIS BY PAIR METHOD (PUNCTURE, ASPIRATION, INJECTION, REASPIRATION).

机构信息

1Syzganov's National Scientific Center of Surgery, Department of HPB Surgery and Liver Transplantation; 2Kazakhstan's Medical University "KSPH", Almaty Kazakhstan.

1Syzganov's National Scientific Center of Surgery, Department of HPB Surgery and Liver Transplantation, Almaty Kazakhstan.

出版信息

Georgian Med News. 2020 Nov(308):11-14.

Abstract

The development of new technologies in medicine lead to creating an optimal treatment methods of cystic liver echinococcosis, based on minimally invasive technologies, such as percutaneous puncture-aspiration echinococcectomy (PAIR) under ultrasound (US) guidance. Aim of this study is to analyze and evaluate the efficiency of PAIR treatment. The study material included a retrospective analysis of 33 patients who underwent PAIR from December 2017 to December 2019. Of them, 25 (75%) patients with primary CLE, 8 (24%) patients with recurrent cystic liver echinococcosis. Cystic liver echinococcosis was staged according to WHO classification by US images. All patients pre- and postoperatively received therapy with Albendazole. The mean duration of surgery was 41 (30-70) min. Hospital stay times were ranged from 2 and 16 days (mean 4,8 days) in all patients. The conversion to laparotomy during the procedure was not necessary. Operation was finished in 3 cases due to developing anaphylactic shock during operation. There was no fatal outcome in any cases. One patient developed bilio-cystic communication, resolved spontaneously without additional treatment. The use of minimally invasive PAIR intervention followed by Albendazole therapy has a positive effect on reducing the patient's hospital stay.

摘要

新技术在医学中的发展导致了基于微创技术的肝包虫病囊性病变的最佳治疗方法的产生,如超声(US)引导下的经皮穿刺抽吸肝包虫病切除术(PAIR)。本研究旨在分析和评估 PAIR 治疗的效果。研究材料包括 2017 年 12 月至 2019 年 12 月期间接受 PAIR 的 33 例患者的回顾性分析。其中,25 例(75%)为原发性 CLE 患者,8 例(24%)为复发性肝包虫病囊性病变患者。肝包虫病囊性病变根据 WHO 分类标准在 US 图像上进行分期。所有患者术前和术后均接受阿苯达唑治疗。手术平均持续时间为 41(30-70)分钟。所有患者的住院时间从 2 天到 16 天不等(平均 4.8 天)。在整个过程中无需转为剖腹手术。由于术中发生过敏性休克,有 3 例手术提前结束。在任何情况下均未发生致命结果。1 例患者发生胆囊肿管沟通,无需额外治疗即可自行缓解。使用微创 PAIR 介入术联合阿苯达唑治疗对缩短患者的住院时间有积极影响。

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