心脏包虫囊肿是一种罕见的寄生虫病。这项研究的目的是描述临床,我们单位20年来的心脏包虫病的病理特征和手术治疗结果。
方法:从1994年5月到2014年5月,在我们单位手术了17例心脏包虫囊肿。总的来说,12例患者为男性(平均年龄25±13岁)。所有患者都抱怨呼吸困难,71%的患者出现胸痛。诊断,根据组织学检查,在超声心动图和胸部计算机断层扫描中怀疑。
结果:我们的研究揭示了五个可能的位置,按频率降序排列:左心室,室间隔,右心室,左心房和肺动脉。外科手术是对囊肿内容物的受控穿刺和抽吸,膀胱切除术(69%),或子宫周切除术(31%)。6例(37.5%)或10例(62.5%)小心闭合。医院死亡率为11.8%(n=2)。发病率以传导异常为标志(n=2),需要手术治疗的残余腔出血和血肿(n=3)。随访11例患者,平均周期为40.5±19.4个月。在后续行动中,既没有晚期死亡,也没有复发.
结论:心脏包虫囊肿是一种严重的疾病,其治疗是手术治疗。膀胱切除术和子宫周切除术仍然是两种能够提供良好治愈机会的手术技术,发病率和死亡率均可接受。
Cardiac hydatid cyst is a rare parasitic disease. The purpose of this study was to describe the clinical, pathological features and the outcome of the surgical treatment of cardiac hydatid disease in our unit over a twenty-year period.
METHODS: Between May 1994 and May 2014, seventeen cases of cardiac hydatid cysts were operated at our unit. Overall, twelve patients were male (mean age 25±13years). All patients were complaining of dyspnea and 71% presented with chest pain. The diagnosis, based on histological examination, was suspected on echocardiography and computed tomography of chest.
RESULTS: Our study revealed five possible locations, which were in decreasing order of frequency: left ventricle, interventricular septum, right ventricle, left atrium and pulmonary artery. The surgical procedure was a controlled puncture and aspiration of the cyst content, with cystectomy (69%), or pericystectomy (31%). The resulting cavity left open in 6 cases (37.5%) or carefully closed in 10 (62.5%). Hospital mortality was 11.8% (n=2). Morbidity was marked by conduction abnormalities (n=2), bleeding and hematoma of the residual cavity that required surgical treatment (n=3). Eleven patients were followed with a mean period of 40.5±19.4 months. At follow-up, neither late deaths nor recurrence have occurred.
CONCLUSIONS: Cardiac hydatid cyst is a serious disease whose treatment is surgical. Cystectomy and pericystectomy remain the two surgical techniques able to offer good chance of cure with acceptable morbidity and mortality.