Kapan Selin, Turhan Ahmet Nuray, Kalayci Mustafa Uygar, Alis Halil, Aygun Ersan
General Surgery Clinic, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
J Gastrointest Surg. 2008 May;12(5):867-71. doi: 10.1007/s11605-007-0458-7. Epub 2007 Dec 18.
In current practice, minimal invazive interventions such as percutaneous drainage and laparoscopic surgery in adjunct treatment with benzimidazoles have been gaining acceptance in treatment of hydatid cystic disease with minimal morbidity and mortality. In this prospective study, the efficacy and validity of primary medical therapy in the treatment of hydatid cystic disease has been investigated.
Sixty-five patients with hepatic cystic disease were treated with albendazole alone between January 2004 and June 2007. All of the patients were administrated albendazole as 10 mg kg(-1) day(-1) divided into two equal doses for 6 months with ultrasonography (USG), serological tests, full-blood cell count and hepatic function tests performed in 2 months intervals in the course of treatment.
Fifty of the patients were female and 15 were male with a mean age of 47.0+/-16.9 (17-80). A total number of 106 cysts were present in 65 patients. Mean cystic diameter was 5.5+/-3.6 (1-16). In 41 of the patients, cysts were solitary and in remaining 24 patients cysts were multiple. Mean follow-up period was 28.3+/-8.6 (12-42) months. The overall success rate of albendazole therapy was 18% (12/65) in the study.
Albendazole therapy for hepatic hydatidosis is not effective in the vast majority of patients and, therefore, should not be used as the primary therapy for patients who are surgical candidates.
在当前的医疗实践中,诸如经皮引流和腹腔镜手术等微创干预措施,在与苯并咪唑类药物联合治疗包虫囊肿病时,因其发病率和死亡率极低而逐渐被广泛接受。在这项前瞻性研究中,我们对原发性药物治疗包虫囊肿病的疗效和有效性进行了调查。
2004年1月至2007年6月期间,65例肝囊肿病患者仅接受阿苯达唑治疗。所有患者均按10mg/kg/天的剂量服用阿苯达唑,分两次等量服用,疗程为6个月。治疗期间每隔2个月进行超声检查(USG)、血清学检测、全血细胞计数和肝功能检测。
患者中50例为女性,15例为男性,平均年龄为47.0±16.9岁(17 - 80岁)。65例患者共有106个囊肿,平均囊肿直径为5.5±3.6cm(1 - 16cm)。其中41例患者的囊肿为单发,其余24例患者的囊肿为多发。平均随访期为28.3±8.6个月(12 - 42个月)。在该研究中,阿苯达唑治疗的总体成功率为18%(12/65)。
阿苯达唑治疗肝包虫病对绝大多数患者无效,因此,对于有手术指征的患者,不应将其作为主要治疗方法。