Velasco-Tirado Virginia, Romero-Alegria Angela, Pardo-Lledías Javier, Alonso-Sardón Montserrat, Lopez-Bernus Amparo, Sampedro Jose Quiñones, Bellvis Luis Muñoz, Iglesias Gomez Alicia, Muro Antonio, Muñoz Bellido Juan Luis, Iglesias-Iglesias Manuel, Jimenez Lopez Marcelo Fernando, Belhassen-García Moncef
Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca (CAUSA), Paseo de San Vicente 58-182, Salamanca.
Instituto de Investigación Biomédica de Salamanca (IBSAL), CAUSA, Hospital Virgen de la Vega 10° planta, Paseo de San Vicente 58-182, Salamanca.
Trans R Soc Trop Med Hyg. 2018 May 1;112(5):207-215. doi: 10.1093/trstmh/try050.
Management options for cystic echinococcosis (CE) remain a serious problem. The main aim of this study was to examine the selection and complications of treatment applied in patients with CE. The second aim was to evaluate the mortality rate and causative factors.
A retrospective descriptive study of patients diagnosed with CE between 1998 and 2015 was conducted, according to ICD-9 (code 122·0 to 122·9) criteria in the Complejo Asistencial Universitario of Salamanca, Spain.
Four-hundred-ninety-one (491) patients were diagnosed with CE disease and the treatment applied in these patients were: 166 (33.8%) patients received only surgery, 176 (35.8%) surgery and drugs, 17 (3.5%) drugs alone, in 131 (26.7%) patients the strategy was 'watch and wait', and only one patient (0.2%) was applied puncture-aspiration-injection-respiration (PAIR). Thus, a total of 342 patients received surgery, either alone (166) or combined with drugs (176), and a total of 193 (39.4%) patients were medically treated, either alone (17) or combined with surgery (176); 123 (63.7%) patients used albendazole alone; and 70 (36.3%) patients used a combination of albendazole and praziquantel. Sixty-five patients (19.0%) had complications after surgery and seven of them (2%) died. Only 15 (7.8%) cases had side effects from anthelmintics. Throughout the study period, 80 (16.3%) patients died, 14 (2.9%) of them due to CE disease.
Complications of CE are one of the most common causes of mortality in CE patients, with size, location, and number of cysts, and the 'watch and wait' treatment strategy being the main factors associated with mortality.
囊性棘球蚴病（CE）的治疗选择仍然是一个严重问题。本研究的主要目的是研究CE患者治疗方法的选择及并发症。第二个目的是评估死亡率及相关因素。
根据国际疾病分类第九版（ICD - 9，编码122·0至122·9）标准，对西班牙萨拉曼卡大学综合医院1998年至2015年间诊断为CE的患者进行回顾性描述性研究。
491例患者被诊断为CE，这些患者接受的治疗方法如下：166例（33.8%）仅接受手术治疗，176例（35.8%）接受手术及药物治疗，17例（3.5%）仅接受药物治疗，131例（26.7%）患者采取“观察等待”策略，仅有1例患者（0.2%）接受穿刺抽吸注射再注入（PAIR）治疗。因此，共有342例患者接受了手术治疗，其中166例单独手术，176例手术联合药物治疗；共有193例（39.4%）患者接受药物治疗，其中17例单独药物治疗，176例药物联合手术治疗；123例（63.7%）患者单独使用阿苯达唑；70例（36.3%）患者联合使用阿苯达唑和吡喹酮。65例患者（19.0%）术后出现并发症，其中7例（2%）死亡。仅15例（7.8%）病例出现驱虫药副作用。在整个研究期间，80例患者（16.3%）死亡，其中14例（2.9%）死于CE疾病。
CE并发症是CE患者最常见的死亡原因之一，囊肿的大小、位置、数量以及“观察等待”治疗策略是与死亡率相关的主要因素。
