包虫囊肿腹腔破裂的相关因素分析及疗效评价
Efficacy evaluation and analysis of factors for hydatid cyst rupture into the peritoneal cavity: A systematic review

摘要：目的 回顾性分析国内外文献中关于包虫囊肿患者发生囊肿腹腔破裂的相关因素及特点，总结其诊治及预防措施。方法 通过文献检索，收集并研究1988年-2014年间中文或英文发表的关于包虫囊肿腹腔破裂的文献，针对文中发生囊肿腹腔破裂的相关因素及特点进行回顾性分析。结果 纳入的包虫囊肿发生破裂的32篇文献中，国外14篇，国内18篇，共2044例资料，按地理分布，国外1007例，国内1037例；囊肿破裂894例，破入腹腔385例；男性491例，女性288例，余未提供；年龄3～76岁，平均年龄39.5岁；囊肿部位多位于肝脏；破裂的囊肿平均直径多大于10cm；囊肿多由外伤致使破裂；囊型包虫破裂后365例患者表现为腹痛、恶心呕吐、腹部压痛及反跳痛明显的腹膜炎体征，随着病情发展，176例患者出现全身过敏性反应，并发皮肤荨麻疹、过敏性休克等；患者白细胞数均会升高，结合临床表现及腹部超声或CT基本可以确诊；治疗均采用紧急手术剖腹探查，多数患者达临床治愈；术前准备时间长短与患者临床表现、及时就诊和确诊相关；紧急手术后327例患者给予阿苯达唑预防复发，复发率低。结论 包虫囊肿破裂主要发生于包虫流行区域，中青年男性常发生破裂，破裂囊肿多位于肝脏，破裂率与囊肿大小相关，破裂后患者主要表现为急腹症及全身过敏反应，及时确诊、紧急手术彻底清除病灶及囊液是治疗的关键，术后应用阿苯达唑可有效预防包虫囊肿复发。
ABSTRACT: Objective To retrospectively analyze domestic and foreign literature regarding the related factors and characteristics of hydatid cysts rupture into the abdominal cavity and summarize its diagnosis, treatment and preventive measures. Methods Through systematic and comprehensive literature search, we collected 32 articles on hydatid cyst rupture into the abdominal cavity, which were published in 1988-2014 in Chinese or English. Results The 32 articles on hydatid cyst rupture consisted of 14 ones published abroad and 18 domestic ones. Geographical distribution: Among the 2044 cases involved, 1007 were distributed abroad and 1037 in China. Types of cyst rupture: rupture in 894 cases and rupture into the abdominal cavity in 385 cases. Sex distribution: 491 male and 288 female patients. Range of age: 3-76 years old, with the mean age of 39.5. The pathogenic site: mostly in the liver. Ruptured cyst size: mostly larger than 10cm in diameter. Causes of rupture: mostly trauma. Clinical symptoms: With cystic hydatid breaking into the abdominal cavity, 365 patients had abdominal pain, nausea, vomiting, abdominal tenderness and obvious signs of peritonitis with bounce pain. As the disease worsened, 176 patients had systemic allergic reaction, concurrent skin urticaria, anaphylactic shock, and increased count of white blood cells. Combined with clinical manifestations and abdominal ultrasound or CT diagnosis, this disease could be confirmed. The treatment of this disease usually adopted emergency laparotomy surgery, after which clinical cure was achieved in most patients, and it was highly dependent on the patient’s clinical manifestation, timely diagnosis and diagnosis. Postoperative application of albendazole hydatid cyst on 327 patients led to low recurrence rate. Conclusion Hydatid cyst rupture mainly occurs in hydatid-prevalent areas and among young and middle-aged men. The symptom of hydatid cyst rupture into the peritoneal cavity is relatively common. Cyst