Aytac A, Yurdakul Y, Ikizler C, Olga R, Saylam A
Ann Thorac Surg. 1977 Feb;23(2):145-51. doi: 10.1016/s0003-4975(10)64088-x.
One hundred patients with pulmonary hydatid disease underwent thoractomy and operative removal of the cysts. Of the 60 men and 40 women, most were between 3 and 19 years old. Cough, fever, dyspnea, and chest pain were the prominent symptoms in the majority of cases. Intact hydatid cysts were found in 67 patients and infected or ruptured cysts in 33. The Casoni skin test, Weinberg reaction, and eosinophilia were found to be unreliable diagnostic criteria and therefore were not used routinely in our patients. Roentgenological examination was the most valuable diagnostic aid. A single lobe was affected in 72 patients. Unilateral multiple foci were present in 15 patients and bilateral multiple foci in 13. Cystectomy and capitonnage were the preferred operative procedures in most cases. Pulmonary resection was necessary to only a limited number of patients. We conclude that conservative surgical methods such as cystectomy (with or without capitonnage) are preferable, especially for children, whose residual lung parenchyma has great capacity for expansion. The mortality rate among our 100 patients was 2%; both died of cardiac arrest during operation.
100例肺包虫病患者接受了开胸手术并切除囊肿。60名男性和40名女性中,大多数年龄在3至19岁之间。咳嗽、发热、呼吸困难和胸痛是大多数病例的主要症状。67例患者发现完整的包虫囊肿,33例为感染或破裂囊肿。发现卡索尼皮试、温伯格反应和嗜酸性粒细胞增多是不可靠的诊断标准,因此在我们的患者中未常规使用。X线检查是最有价值的诊断辅助手段。72例患者单叶受累。15例患者为单侧多发病灶,13例为双侧多发病灶。大多数情况下,囊肿切除术和内翻缝合术是首选的手术方法。仅少数患者需要进行肺切除术。我们得出结论,保守的手术方法如囊肿切除术(有或无内翻缝合)更可取,特别是对于儿童,其残余肺实质具有很大的扩张能力。我们100例患者的死亡率为2%;两人均死于手术期间的心脏骤停。