Yetim Ibrahim, Erzurumlu Kenan, Hokelek Murat, Baris Sancar, Dervisoglu Adem, Polat Cafer, Belet Umit, Buyukkarabacak Yalçin, Guvenli Abdullah
Department of General Surgery, Medical Faculty, Ondokuzmayis University, Samsun, Turkey.
J Gastroenterol Hepatol. 2005 Sep;20(9):1442-7. doi: 10.1111/j.1440-1746.2005.03843.x.
Percutaneous drainage with alcohol injection for hydatid cysts has been commonly used in the last two decades. Albendazole is the drug of choice in the medical treatment of hydatidosis, and has also been used as an intraoperative scolicidal solution. The side-effects of its local application are not well known and have not been investigated. The purpose of the present study was to investigate the effects of the intracystic injections of alcohol and albendazole solutions on the hydatid cysts and hepatobiliary system of rabbits.
There were three groups of eight rabbits: a control group, an alcohol group and an albendazole group. In all groups hepatic hydatidosis was obtained. The control group received no therapeutic procedure. Cyst liquid was aspirated, and alcohol or albendazole solutions were injected in the other two study groups. alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) levels, echinococcus indirect hemagglutination (IHA) tests, and the size and volume of the residual cysts were investigated. Liver was histopathologically evaluated.
The ALT, AST, GGT, and alkaline phosphatase (ALP) levels were significantly higher in the alcohol group, whereas echinococcus IHA level was highest in the control group than in the study groups. Albendazole had similar effects but of a lesser degree (P < 0.01). After therapy, the cyst volume was greater in the control than in the albendazole group (P < 0.01). In histopathological evaluation hepatocellular necrosis, portal inflammation and fibrosis were most severe in the alcohol group (P < 0.01).
Alcohol and albendazole solutions are effective as scolicidal solutions. Higher scolicidal effect and lesser side-effects on hepatobiliary system are the advantages of albendazole solution.
在过去二十年中，经皮穿刺酒精注射治疗包虫囊肿已被广泛应用。阿苯达唑是治疗包虫病的首选药物，也被用作术中杀头节剂。其局部应用的副作用尚不明确，也未得到研究。本研究的目的是探讨囊内注射酒精和阿苯达唑溶液对兔包虫囊肿和肝胆系统的影响。
将24只兔分为三组，每组8只：对照组、酒精组和阿苯达唑组。所有组均诱发肝包虫病。对照组不接受任何治疗措施。抽取囊液，在另外两个研究组中注射酒精或阿苯达唑溶液。检测丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和γ-谷氨酰转移酶（GGT）水平、棘球蚴间接血凝试验（IHA），并观察残留囊肿的大小和体积。对肝脏进行组织病理学评估。
酒精组的ALT、AST、GGT和碱性磷酸酶（ALP）水平显著升高，而对照组的棘球蚴IHA水平高于研究组。阿苯达唑有类似作用，但程度较轻（P<0.01）。治疗后，对照组的囊肿体积大于阿苯达唑组（P<0.01）。组织病理学评估显示，酒精组肝细胞坏死、门脉炎症和纤维化最为严重（P<0.01）。
酒精和阿苯达唑溶液作为杀头节剂有效。阿苯达唑溶液的优点是杀头节效果更高，对肝胆系统的副作用更小。
