Su Xun,Li Wanfu,Liu Hui,et al.Analysis of factors associated with cyst rupture in pediatric hepatic cystic echinococcosis[J].Journal of Clinical Pediatric Surgery,,():957-962.[doi:10.3760/cma.j.cn101785-202308004-010]
Analysis of factors associated with cyst rupture in pediatric hepatic cystic echinococcosis
- Keywords:
- Echinococcosis; Hepatic; Cysts; Hepatic; Rupture; Cysts; Correlation of Data; Child
- Abstract:
- Objective To explore the factors associated with cyst rupture in pediatric hepatic cystic echinococcosis,and provide clinical reference for diagnosis and treatment. Methods A retrospective analysis was conducted on the clinical data of 100 pediatric patients with hepatic echinococcosis treated in the Department of Pediatric General Surgery at the First Affiliated Hospital of Xinjiang Medical University from 2017 to 2023.Based on whether cyst rupture occurred,patients were divided into a rupture group and a non-rupture group.Clinical symptoms,laboratory indicators,imaging findings,and intraoperative conditions were collected and compared between the two groups. Results All 100 patients successfully underwent surgery.Among them,41 experienced cyst rupture,including 17 with rupture into the abdominal cavity,14 with rupture into the bile duct accompanied by biliary fistula,and 10 with isolated endocyst rupture; the remaining 59 patients had no rupture.Univariate analysis revealed significant differences between the rupture and non-rupture groups in the incidence of abdominal pain (22 cases [53.7%]vs.18 cases [30.5%],χ2=5.402,P=0.020),vomiting (9 cases [22.0%]vs.2 cases [3.4%],χ2=6.722,P=0.010),elevated white blood cell count (16 cases [39.0%]vs.7 cases [11.9%],χ2=10.076,P=0.002),cyst diameter (median 10 [8.5,12]cm vs.9 [8,10]cm,Z=2.623,P=0.009),cyst location (multiple cysts involving both hepatic lobes:14 cases [34.1%]vs.9 cases [15.3%],χ2=4.875,P=0.027),and cyst infection (23 cases [56.1%]vs.16 cases [27.1%],χ2=8.539,P=0.003).Multivariate binary logistic regression analysis indicated that cyst diameter ≥ 10cm(OR=3.766,95%CI:1.328-10.683),multiple cysts involving both hepatic lobes(OR=3.265,95%CI:1.039-10.264),and cyst infection(OR=4.123,95%CI:1.463~11.619) were independent risk factors for cyst rupture (P＜0.05).Conclusions Cyst diameter≥10 cm,multiple cysts distributed across both liver lobes,and cyst infection are key predictors for rupture of hepatic cystic echinococcosis in children,offering valuable clinical reference.
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Memo
收稿日期:2024-8-3。
通讯作者:李万富,Email:13699982169@163.com