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首页> 外文期刊>Journal of Pediatric Surgery: Official Journal of the Surgical Section of the American Academy of Pediatric, the British Association of Paediatric Surgeons, the American Pediatric Surgical Association, and the Canadian Association of Paediatric Surgeons >Diagnosis and management of hydatid liver disease in children: A report of 156 patients with hydatid disease
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Diagnosis and management of hydatid liver disease in children: A report of 156 patients with hydatid disease

机译：小儿hy虫肝病的诊治：156例hy虫病患者的报告

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Background/Purpose: There are many published reviews on adult hydatid disease and a guideline published by World Health Organization Informal Working Group (WHO-IWGE) in 2010. However, there are very few reports on hydatid liver disease in children with limited numbers of patients, and no comments were offered on childhood hydatid liver disease in the WHO-IWGE 2010 guideline. The aim of this study is to present our 17-year experience with 156 pediatric patients with hydatid liver disease and provide a treatment algorithm for children. Methods: The clinical records of 156 children with hydatid liver disease treated from January 1994 to January 2011 were retrospectively reviewed. Patient sex, age at diagnosis, symptoms, disease location, cyst numbers and sizes, treatment choices, medical treatment duration, surgical methods, and complications were recorded. Treatment of liver hydatidosis included 3 different schedules: (1) small (<5 cm) liver cysts treated with albendazole (ABZ) only, (2) cysts (>5 cm) located at the liver surface treated with surgery combined with ABZ, and (3) all (>5 cm) liver cysts embedded deep in the liver parenchyme treated with percutaneous drainage and ABZ. Albendazole was given (10 mg/kg twice a day) and continued for 6 months after initial therapy. Results: There were 92 boys and 64 girls with an average age of 9.2 years (range, 1.1-15 years). A total of 376 cysts were detected in 156 patients. The follow-up period ranged from 1 to 10 years (median, 6.5 years). Complications were classified according to the Dindo classification. After the first 6 months of therapy, grade I complications occurred in 12.1% of patients, grade II complications in 7.4%, and grade IIIb complications in 7.3%. There were no grade IIIa, IVa, or IVb complications. At 1 year, grade II complications were recorded in 9.6% of 15 patients, and grade IIIb complications, in 1.2% of patients. During the 17 years reviewed, there were no mortalities (0% grade V complications). Conclusions: Based on this experience, we believe that suitable treatment should be chosen based on factors such as cyst number, cyst location (on the surface or deep in the organ), proximity to vascular structures, whether the cyst is complicated, and additional organ involvement or not. In addition, although the results of our study mostly agree with the results in the WHO-IWGE 2010 report, there are some noticeable differences between these 2 studies. Hence, we believe that the WHO-IWGE 2010 recommendations should be updated by incorporating the childhood observations.
机译：背景/目的：2010年，世界卫生组织非正式工作组（WHO-IWGE）发布了许多有关成人adult虫病的评论和指南。但是，关于患者数有限的儿童hy虫病的报道很少。 ，并且在WHO-IWGE 2010指南中未提供有关儿童hy虫肝病的评论。这项研究的目的是向156名小儿包虫肝病患者介绍我们17年的经验，并为儿童提供治疗方法。方法：回顾性分析1994年1月至2011年1月收治的156例小儿包虫肝病的临床资料。记录患者的性别，诊断年龄，症状，疾病位置，囊肿数量和大小，治疗选择，药物治疗时间，手术方法和并发症。肝包虫的治疗包括3种不同的时间表：（1）仅用阿苯达唑（ABZ）治疗的小（<5 cm）肝囊肿;（2）结合ABZ进行手术治疗的位于肝表面的囊肿（> 5 cm）;以及（3）经皮引流和ABZ处理的所有（> 5 cm）肝囊肿均深埋于肝实质中。给予阿苯达唑（每天两次，每次10 mg / kg），并在初始治疗后持续6个月。结果：平均年龄为9.2岁（范围：1.1-15岁）的男孩和64位女孩为92岁。在156例患者中共检测到376个囊肿。随访时间为1到10年（中位数为6.5年）。根据Dindo分类对并发症进行分类。在治疗的前6个月后，I级并发症发生在12.1％的患者中，II级并发症发生在7.4％，IIIb级并发症发生在7.3％。没有IIIa，IVa或IVb级并发症。在1年时，记录的15例患者中有9.6％发生II级并发症，而1.2％的患者中发生了IIIb级并发症。在回顾的17年中，没有死亡（V级并发症为0％）。结论：基于这一经验，我们认为应根据囊肿数量，囊肿位置（在器官的表面或深处），与血管结构的接近程度，囊肿是否复杂以及其他器官等因素选择合适的治疗方法是否参与。此外，尽管我们的研究结果与WHO-IWGE 2010报告的结果基本一致，但这两项研究之间还是存在一些明显的差异。因此，我们认为应通过纳入儿童期观察来更新WHO-IWGE 2010建议。

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