Vara-Thorbeck R, Morales O I, Vara-Thorbeck C
Zentralbl Chir. 1986;111(4):188-95.
Reported in this paper are 178 patients who had received surgical treatment for echinococciasis of the liver, among them 144 at the Surgical Hospital of Madrid University, between 1962 and 1970, and another 34 at the Surgical Hospital of Granada University, between 1971 and 1982. All of them had been carriers of Echinococcus cysticus. Echinococciasis of the liver usually is not diagnosed until the hydatid cyst begins to cause conspicuous symptoms or complications on account of its own growth. Diagnostic clues are obtainable from laboratory findings (eosinophilia in excess of four per cent), immune reaction, complement fixation reaction according to Weinberg, and intracutaneous test according to Casoni. Diagnosis of the authors' cases had been preceded by scintiscanning. Surgical removal of echinococcus cysts from the liver calls for an undogmatic approach. From among all surgical methods applicable to cyst removal the authors have most frequently used closed marsupialisation, according to Posadas-Dew (65.8 per cent of all cases). Drainage marsupialisation was applied to 25.8 per cent of all cases. The postoperative lethality amounted to 2.3 per cent. Morbidity was low.
本文报告了178例接受肝包虫病手术治疗的患者,其中144例于1962年至1970年在马德里大学外科医院接受治疗,另外34例于1971年至1982年在格拉纳达大学外科医院接受治疗。他们均为囊型包虫病携带者。肝包虫病通常在包虫囊肿因其自身生长开始引起明显症状或并发症时才得以诊断。诊断线索可从实验室检查结果(嗜酸性粒细胞增多超过4%)、免疫反应、温伯格补体结合反应以及卡索尼皮内试验中获得。作者的病例在诊断前均进行了闪烁扫描。肝包虫囊肿的手术切除需要采取不教条的方法。在所有适用于囊肿切除的手术方法中,作者最常采用的是根据波萨达斯 - 德乌的封闭袋形缝术(占所有病例的65.8%)。引流袋形缝术应用于所有病例的25.8%。术后死亡率为2.3%。发病率较低。