Polat Cafer, Dervisoglu Adem, Hokelek Murat, Yetim Ibrahim, Buyukkarabacak Yalcin, Ozkutuk Yasin, Erzurumlu Kenan
Department of General Surgery, Ondokuz Mayis University, Medical School, Kurupelit, Samsun, Turkey.
J Gastroenterol Hepatol. 2005 Mar;20(3):421-5. doi: 10.1111/j.1440-1746.2004.03535.x.
Hepatic hydatidosis still remains as a serious problem in general surgery. Recurrence and/or secondary hydatidosis rates are up to 25% in the cases treated with surgery alone. Albendazole is the most commonly used drug in the medical treatment of echinococcosis. The aim of the present study was to evaluate the effect of albendazole using the intraoperative and perioperative periods as dual therapy.
Fifty-two cases of hepatic hydatidosis were evaluated and treated by dual treatment of albendazole together with surgery. Perioperative albendazole treatment was given in a dose of 12-15 mg/kg per day in four divided doses. The treatment started 2-28 days before the surgery when the diagnosis was established and continued for 2-24 months (4.76 +/- 3.25) postoperatively in a cyclic monthly form. A total of 1.7 microg/mL albendazole solution was used as a protoscolicidal agent in the cystic cavity intraoperatively. In the postoperative period serology, ultrasonography and computed tomography evaluations were done. The follow-up period was 5-92 months (mean: 62.48 months).
There was no recurrence in the present study. One patient died in the 6th postoperative week due to cerebral hydatidosis and multiple organ failure. Early and late morbidity rates were 7.69 and 9.61%, respectively.
Dual albendazole treatment is effective in the prevention of recurrences and/or secondary hydatidosis.
肝包虫病在普通外科中仍然是一个严重问题。仅接受手术治疗的病例中，复发率和/或继发性包虫病发生率高达25%。阿苯达唑是棘球蚴病药物治疗中最常用的药物。本研究的目的是评估在术中及围手术期使用阿苯达唑进行双重治疗的效果。
对52例肝包虫病患者进行评估，并采用阿苯达唑与手术联合治疗。围手术期阿苯达唑治疗剂量为每日12 - 15 mg/kg，分4次服用。治疗在确诊后手术前2 - 28天开始，术后以每月循环的方式持续2 - 24个月（4.76±3.25）。术中在囊腔内使用浓度为1.7μg/mL的阿苯达唑溶液作为原头蚴杀灭剂。术后进行血清学、超声和计算机断层扫描评估。随访期为5 - 92个月（平均：62.48个月）。
本研究中无复发病例。1例患者在术后第6周因脑包虫病和多器官衰竭死亡。早期和晚期发病率分别为7.69%和9.61%。
阿苯达唑双重治疗在预防复发和/或继发性包虫病方面有效。
