顶置手术对所有类型的肺包虫病均有效

Omer M. T. Hammodat, B. Alhajjar, Ahmad Hammodat
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引用次数: 0

摘要

背景:包虫囊肿仍在世界范围内分布,每年在流行地区发现许多病例。它倾向于累及肝脏和肺部。长期以来,为了避免术后并发症,主要是气漏和脓胸的形成,人们一直在使用capitonation。目前,对于复杂包虫病的治疗效果仍存在争议,我们对此进行了评价。目的:探讨肺包虫病合并合并及非合并合并肺包虫病行资本化手术对减少术后并发症及住院时间的疗效。患者和方法:2017年2月至2019年12月,在伊拉克摩苏尔右侧的AlJumhory教学医院胸外科、Al-Khansaa教学医院儿科外科和Al-Rabee私立医院进行了一项前瞻性研究。本研究共纳入118例肺包虫囊肿患者,包括不同年龄、不同类型的复杂和非复杂囊肿。合并症如急性心肌缺血和未控制的糖尿病被排除在我们的研究之外。根据患者的性别、年龄、临床表现、囊肿状况(大小、部位和破裂部位)和术后住院时间对患者进行评估。所有患者均行硬核摘除术。随访3个月,以月为间隔,每年平均随访22个月。结果:本组患者118例,中位年龄32岁。本研究中49例(41.5%)为完整囊肿,69例(58.5%)为破裂囊肿。术后早期并发症包括漏气10例,肺不张8例,气胸3例,伤口感染3例,咯血2例。结论:肺包虫病合并和非合并肺包虫病加气治疗可降低漏气发生率,缩短住院时间。
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Capitonnage surgery is effective in all types of pulmonary hydatid cysts
Background: Hydatid cyst still has worldwide distribution with many cases discovered yearly in endemic areas. It has a predilection to involve the liver and the lung. Capitonnage has been practiced long time to avoid postoperative complications mainly air leak in addition to empyema formation. It may be still controversy concerning the efficiency of capitonnage especially for complicated hydatid cyst which led us to evaluate. Aim of the study: To assess the efficacy of capitonnage surgery in minimizing the postoperative complications and hospital stay in complicated and non complicated pulmonary hydatid cysts. Patients and Methods: A prospective study has been done at the department of thoracic surgery in AlJumhory teaching hospital at right side of Mosul, Department of pediatric surgery in Al-Khansaa teaching hospital and in Al-Rabee private hospital at left side of Mosul / Iraq between February 2017 and December 2019. Totally 118 patients with hydatid cyst of lung, including all ages and on different types of complicated and non-complicated cysts were included for this study. Co-morbid diseases like acute myocardial ischemia and uncontrolled diabetes mellitus were excluded from our study. Patients were evaluated in responce to the gender, age, clinical presentation, cyst condition (size, site and where ruptured or not) and postoperative hospital stay. Enucleation of the HC and capitonnage were carried out for all patients. The patient followed for three months at monthly interval, then each year with the mean follow up of 22 months. Results: One hundred eighteen patients with median age of 32 years were operated using capitonnage method. In this study 49 (41.5%) of the patients found to have intact cyst and the remaining 69 (58.5%) had ruptured cyst. We recorded the early postoperative complications which include air leak in 10 cases, Atelectasis 8, pneumothorax 3, wound infection 3 and Hemoptysis in 2 cases. Conclusion: Capitonnage can decrease the incidence of air leak and shorten hospital stay in complicated and non-complicated lung hydatid cysts.
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