Smego Raymond A, Bhatti Sabha, Khaliq Amir A, Beg M Asim
Department of Medicine, Aga Khan University, Karachi, Pakistan.
Clin Infect Dis. 2003 Oct 15;37(8):1073-83. doi: 10.1086/378275. Epub 2003 Sep 23.
Using meta-analysis methodology, we compared the clinical outcomes for 769 patients with hepatic cystic echinococcosis treated with percutaneous aspiration-injection-reaspiration (PAIR) plus albendazole or mebendazole (group 1) with 952 era-matched historical control subjects undergoing surgical intervention (group 2). The rate of clinical and parasitologic cure (P<.0001) was greater in patients receiving PAIR plus chemotherapy. Disease recurrence (P<.0001), major complications (anaphylaxis, biliary fistula, cyst infection, liver/intra-abdominal abscess, and sepsis; P<.0001), minor complications (P<.0001), and death (P<.0824) occurred more frequently among surgical control subjects. Fever (P<.002) and minor allergic reactions subjects (P<.0001) were more common among PAIR-treated subjects. The mean durations of hospital stay were 2.4 days for group 1 and 15.0 days for group 2 (P<.001). Compared with surgery, PAIR plus chemotherapy is associated with greater clinical and parasitologic efficacy; lower rates of morbidity, mortality, and disease recurrence; and shorter hospital stays.
我们采用荟萃分析方法，将769例接受经皮穿刺抽吸-注射-再抽吸（PAIR）联合阿苯达唑或甲苯达唑治疗的肝囊性包虫病患者（第1组）与952例接受手术干预的同期历史对照受试者（第2组）的临床结局进行了比较。接受PAIR联合化疗的患者临床和寄生虫学治愈率更高（P<0.0001）。手术对照组受试者的疾病复发率（P<0.0001）、主要并发症（过敏反应、胆瘘、囊肿感染、肝/腹腔内脓肿和脓毒症；P<0.0001）、次要并发症（P<0.0001）和死亡率（P<0.0824）更高。发热（P<0.002）和轻微过敏反应（P<0.0001）在接受PAIR治疗的受试者中更为常见。第1组的平均住院天数为2.4天，第2组为15.0天（P<0.001）。与手术相比，PAIR联合化疗具有更高的临床和寄生虫学疗效；更低的发病率、死亡率和疾病复发率；以及更短的住院时间。
