Abstract: Objective To explore the therapeutic effect of ultrasound guided microwave ablation on liver hydatid disease and the risk factors of postoperative infection. Method The clinical data of 90 patients with hepatic echinococcosis admitted to Yushu People's Hospital from August 2020 to April 2022 were retrospectively analyzed. The patients were grouped according to different treatment methods. 32 patients treated with conventional open surgery were divided into control group, and 48 patients treated with ultrasound-guided microwave ablation were divided into observation group. All patients were followed up for 1 year to compare the incidence of complications. Subsequently, the patients with postoperative infection were divided into two subgroups, namely infected group (n=21) and non-infected group (n=59). The risk factors affecting postoperative infection of hepatic hydatidosis were analyzed, and logistic regression analysis was applied to analyze the independent influencing factors of postoperative infection of hepatic hydatidosis. Result The total response rate of the observation group was 89.58%, the total response rate of the control group was 87.50%. There was no statistical difference between the two groups (P>0.05). The incidence of postoperative complications such as infection, ascites, bile leakage, and liver insufficiency in the observation group was higher than that in the control group (P<0.05). There were no significant differences in gender, lesion site, combined hypertension, hyperlipidemia, other related underlying diseases, hydatid types, postoperative subphrenic effusion or residual cavity between the non-infected group and the infected group (P>0.05). There was no statistical significance in age, proportion of patients diagnosed with diabetes, surgical method, drainage indentation time and hepatic hydatid history between the non-infected group and the infected group (P<0.05). Age, proportion of patients diagnosed with diabetes, operation method, drainage indentation time and hepatic hydatid history were independent risk factors for postoperative infection of hepatic hydatid (OR=2.774, 95% CI=1.876~4.010, P=0.016; OR=0.371, 95% CI=1.876~4.010, P=0.021; OR=0.544, 95% CI=1.876~4.010, P=0.009; OR=0.747, 95% CI=1.876~4.010, P=0.024; OR=0.526, 95% CI=1.876~4.010, P=0.013). Conclusion Both ultrasound-guided microwave ablation and conventional open surgery have significant therapeutic effects on liver hydatid disease, but adopting ultrasound-guided microwave ablation can reduce the incidence of postoperative complications in patients. In addition, for older patients with diabetes and a history of liver echinococcosis, microwave ablation should be used as far as possible to reduce the drainage tube retention time to prevent postoperative infection.

Key words: ultrasound guided microwave ablation, hepatic hydatid disease, postoperative infection, risk factors, complication