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 Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar 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 diseases is 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.
[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) 分型标准, 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。.
Keywords: Child; Gallbladder related complication; Hepatic alveolar echinococcosis; Influencing factor; Qinghai Province.