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目的总结肝包虫病的临床诊治经验。方法回顾性分析首都医科大学附属北京友谊医院2009-2014年收治的11例肝包虫病患者的症状、诊断、治疗及预后情况。结果本组11例,男5例,女6例,年龄20~49岁。8例以腹痛就诊,3例因体检时发现肝占位就诊。既往曾患包虫病者2例;8例有牧区居住史,3例虽无牧区居住史,但有牛、羊等动物密切接触史。11例患者均经腹部影像学检查发现肝内有囊性占位,结合流行病学史及寄生虫试验诊断为肝包虫病,结合病情制定治疗方案。11例中4例行内囊摘除术,2例行外囊摘除术,3例行内囊摘除术+包括囊腔在内的肝部分切除术,1例行内囊摘除术+小肠部分切除术,1例行内囊摘除术+腹腔包虫切除术;术前及术后应用阿苯达唑,20 mg/(kg·d),疗程6~12个月。除1例包虫病患者病情较重,术后1个月出现复发外,其余均临床治愈。结论肝包虫病确诊后首选手术治疗,同时进行阿苯达唑治疗可取得较好的疗效。
Objective To summarize the clinical diagnosis and treatment of hepatic hydatid disease. Methods Retrospective analysis of the symptoms, diagnosis, treatment and prognosis of 11 patients with hepatic hydatid disease admitted to Beijing Friendship Hospital affiliated to Capital Medical University from 2009 to 2014 were retrospectively analyzed. Results The group of 11 patients, 5 males and 6 females, aged 20 to 49 years. Eight patients were treated with abdominal pain and three patients were diagnosed with liver cancer because of physical examination. Past cases of hydatid disease in 2 cases; 8 cases of pastoral areas of residence history, although no pastoral area 3 cases of living history, but there are cattle, sheep and other animals in close contact with history. Eleven patients underwent abdominal imaging examination of cystic lesions in the liver, combined with epidemiological history and parasite diagnosis of liver hydatid disease, combined with the disease to develop treatment options. In 11 cases, 4 cases underwent enucleation, 2 cases underwent enucleation, 3 cases underwent internal capsule resection + partial hepatectomy including cyst, 1 case underwent internal capsule enucleation + partial small bowel resection , 1 case of intracapsular enucleation + abdominal hydatid resection; application of albendazole before and after surgery, 20 mg / (kg · d), treatment of 6 to 12 months. In addition to a case of hydatid disease in patients with severe, recurrence after 1 month, the rest were clinically cured. Conclusion Liver hydatidosis after the diagnosis of the first choice of surgical treatment, while albendazole treatment can achieve better results.