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,2025,(10):957-962.[doi:10.3760/cma.j.cn101785-202308004-010]
儿童肝细粒棘球蚴病囊肿破裂相关因素分析
- Title:
- Analysis of factors associated with cyst rupture in pediatric hepatic cystic echinococcosis
- Keywords:
- Echinococcosis; Hepatic; Cysts; Hepatic; Rupture; Cysts; Correlation of Data; Child
- 摘要:
- 目的 探讨儿童肝细粒棘球蚴病囊肿破裂相关因素,为临床诊治儿童肝细粒棘球蚴病提供参考。方法 回顾性分析2017—2023年新疆医科大学第一附属医院小儿普外科收治的100例肝细粒棘球蚴病患儿临床资料。根据是否发生囊肿破裂,分为破裂组和未破裂组,收集并对比两组患儿临床症状、实验室指标、影像学表现以及术中情况。结果 100例均顺利完成手术,41例发生囊肿破裂,其中破入腹腔17例,破入胆道合并胆瘘14例,单纯内囊破裂10例;59例未发生囊肿破裂。单因素分析显示,破裂组和未破裂组在腹痛[22(53.7%)比18(30.5%),χ2=5.402,P=0.020]、呕吐[9(22.0%)比2(3.4%),χ2=6.722,P=0.010]、白细胞计数升高[16(39.0%)比7(11.9%),χ2=10.076,P=0.002]、囊肿长径[10(8.5,12)cm比9(8,10)cm,Z=2.623,P=0.009]、囊肿位置[多发且分布在两侧肝叶:14(34.1%)比9(15.3%),χ2=4.875,P=0.027]以及囊肿感染[23(56.1%)比16(27.1%),χ2=8.539,P=0.003]上比较,差异有统计学意义(P＜0.05)。多因素Logistic回归分析显示,囊肿长径≥10 cm(OR=3.766,95%CI:1.328~10.683)、囊肿多发且分布在两侧肝叶(OR=3.265,95%CI:1.039~10.264)以及囊肿感染(OR=4.123,95%CI:1.463~11.619)是囊肿破裂的独立危险因素(P＜0.05)。结论 囊肿长径≥10 cm、囊肿多发且分布于两侧肝叶以及囊肿感染是预测儿童肝细粒棘球蚴病囊肿破裂的关键指标,对疾病诊治有一定临床参考价值。
- 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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备注/Memo
收稿日期:2024-8-3。
通讯作者:李万富,Email:13699982169@163.com