肝泡状棘球蚴病不同手术疗效及预后的分析研究

目的:比较肝泡状棘球蚴病(HAE)不同手术方式的疗效,并分析影响HAE手术患者预后的相关因素。方法:回顾性分析2003年9月-2015年2月期间在我院进行手术治疗的HAE病人的诊疗记录。根据手术方式的不同,将病人分为非移植性根治性切除组(A组)、术中病灶绝大部分切除(90%以上)组(B组)、术中不能90%以上切除或仅引流组(C组)、肝移植组(D组)。结合随访资料,评价四组的疗效,并分析影响患者预后的相关因素。结果:A组死亡率低于其他三组,差异具有统计学意义(P0.001)。生存曲线结果显示,A组预后生存状况优于其他三组,差异具有统计学意义(P=0.001)。多因素分析结果表明,非移植性根治性切除、术中出血量是影响患者生存的独立危险因素(均P0.05)。结论:在早期发现早期诊断的前提下,对HAE病人行非移植性根治性切除术治疗效果最好,且非移植性根治性切除是患者预后的独立危险因素。

Analysis on Efficiency and Prognosis of Different SurgeryWays for Hepatic Alveolar Echinococcosis

Objective:To compare the efficiency of different surgery ways for hepatic alveolar echinococcosis (HAE),and analyze the risk factors of their prognosis.Methods:Retrospectively analyzed the medical records of HAE patients who were underwent surgery in our hospital from September 2003 to February 2015. According to the different surgery ways, all patients were divided into follow 4 groups:non-transplanted radical resection group(group A), most of the lesion resection group(removed more than 90%, group B), lesion removed less than 90%or drainage group (group C), liver transplantation group (group D), then evaluated the efficiency for four groups and analyzed the risk factors of their prognosis.Results:Mortality in group A was lower than other three groups, the difference was statistically significant (P<0.001). The Survival function showed than the survival situation in group A was better than other three groups, the difference was statistically significant (P=0.001). Multivariate analysis showed that non-transplanted radical resection, surgery blood loss were the independent risk factors that impacting the survival of HAE patient (P<0.05).Conclusion:On condition of earlier discovery and diagnosis, non-transplanted radical resection is the most effective therapy for HAE patients and it is the independent risk factors of their prognosis.