中国血吸虫病防治杂志 ›› 2018, Vol. 30 ›› Issue (6): 640-645.

• 论著 • 上一篇    下一篇

青海省少年儿童肝多房棘球蚴病与胆囊并发症发生的相关因素分析

徐正光1,韩秀敏1△*,石兵强1,2,王向前1,孙艳秋1,郭亚民1,赵顺云1   

  1. 1青海省人民医院(西宁810000);2青海大学
  • 出版日期:2019-03-02 发布日期:2019-03-05
  • 通讯作者: 韩秀敏
  • 作者简介:徐正光,男,副主任医师。研究方向:棘球蚴病临床治疗
  • 基金资助:
    青海省医药卫生科技项目(2016?wjzdx?23);青海省科技合作专项(2019?HZ?803)

Analysis of related factors for hepatic alveolar echinococcosis and gallbladder complications of children in Qinghai Province

XU Zheng-Guang1, HAN Xiu-Min1△*, SHI Bing-Qiang1,2, WANG Xiang-Qian1, SUN Yan-Qiu1, GUO Ya-Min1, ZHAO Shun-Yun1   

  1. 1 Qinghai Provincial People’s Hospital, Xining 81000, China; 2 Qinghai University, China
  • Online:2019-03-02 Published:2019-03-05
  • Contact: HAN Xiu?Min

摘要: 目的 分析青海省少年儿童肝多房棘球蚴病患者中胆囊相关疾病的分布特征及相关因素。方法 收集2012年1月-2017年12月青海省人民医院住院的未满18周岁的肝多房棘球蚴病患者临床资料,分析经手术治疗的患者中胆囊相关并发症发生的影响因素。结果 共收集51例少年儿童肝多房棘球蚴病患者。按照WHO棘球蚴病PNM影像学分型标准,P1、P2、P3型分别占37.25%(19/51)、41.18%(21/51)和19.60%(10/51)。按照《包虫病诊断标准》(WS 257-2006)诊断标准,51例患者中浸润型、钙化型、液化空洞型分别占66.67%(34/51)、21.57%(11/51)和11.76%(6/51)。患者中术前有胆道系统临床症状者占78.43%(40/51),有胆囊相关并发症者占58.82% (30/51)。对40例多房棘球蚴病患者实施手术,术后有并发症者占77.50%(31/40)。Logistic回归分析结果表明,WHO影像学分型、《包虫病诊断标准》(WS 257-2006)分型、病灶位置、病灶肝段分布、病灶大小、病灶数量等是少年儿童肝多房棘球蚴病胆囊相关并发症发生的危险因素。结论 青海省少年儿童肝多房棘球蚴病患者中胆囊相关并发症的发生率较高,对患者手术方式、术后并发症的发生及预后影响较大,早期诊断和治疗尤为重要。 

关键词: 肝多房棘球蚴病, 胆囊相关并发症, 少年儿童, 影响因素, 青海省

Abstract: Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospitalfrom January 2012 to December 2017, and the gallbladder?related complications in the surgically treated patients with hepatic alveolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257-2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder?related complications. The operations were performed on 40 patients, and 77.50%(31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseasesis higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Key words: Hepatic alveolar echinococcosis; Gallbladder related complication; Child; Influencing factor, Qinghai Province

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