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晚期盆腔包虫骨病的姑息治疗。

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease.

机构信息

Department of Spine Surgery, The Six Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

Am J Trop Med Hyg. 2023 Jul 31;109(3):645-649. doi: 10.4269/ajtmh.23-0267. Print 2023 Sep 6.

Abstract

Hydatid bone disease is a zoonotic parasitic infection that is caused primarily by the tapeworm Echinococcus granulosus, and it continues to be a major public health concern in pastoral regions. The reconstruction of limb function after limb salvage surgery remains a challenge for clinicians. The purpose of this study was to determine the clinical efficacy of palliative treatment of the management of advanced pelvic hydatid bone disease. From March 2005 to December 2018, medical records and images of patients with advanced pelvic hydatid bone disease treated with surgery combined with antiparasitic chemotherapy were evaluated retrospectively. The Enneking classification was applied to determine the location of the lesion, and the Musculoskeletal Tumor Society score system was used for outcome evaluation. Fifteen patients who met the criteria were included in this study, with a mean follow-up of 4.40 ± 1.76 years. All patients received treatment with surgery combined with antiparasitic chemotherapy. The mean number of surgical interventions per patient for pelvic cystic echinococcosis was 5.3 (range, 2-9 interventions per patient). Recurrence of pelvic hydatid bone disease occurred in 5 patients and was managed successfully through repeated debridement procedures. Palliative treatment with limb salvage surgery was an effective and practical approach to the management of advanced pelvic hydatid bone disease. Standard antiparasitic chemotherapy, which included albendazole at a dose of 10 mg/kg/day administered in two daily doses for 3 to 6 months, was also considered an essential part of the overall treatment strategy.

摘要

包虫病是一种人畜共患的寄生虫感染,主要由带绦虫棘球蚴引起,在牧区仍然是一个主要的公共卫生问题。保肢手术后肢体功能的重建仍然是临床医生面临的挑战。本研究旨在确定手术联合抗寄生虫化疗治疗晚期骨盆包虫病的临床疗效。回顾性分析 2005 年 3 月至 2018 年 12 月手术联合抗寄生虫化疗治疗晚期骨盆包虫病患者的病历和影像学资料。应用 Enneking 分类确定病变部位,采用 Musculoskeletal Tumor Society 评分系统进行疗效评价。本研究共纳入 15 例符合标准的患者,平均随访 4.40±1.76 年。所有患者均接受手术联合抗寄生虫化疗治疗。骨盆囊性包虫病患者的平均手术干预次数为 5.3 次(范围为 2-9 次/例)。5 例患者出现骨盆包虫病复发,经反复清创术成功治疗。保肢手术姑息治疗是治疗晚期骨盆包虫病的一种有效且实用的方法。标准的抗寄生虫化疗,包括阿苯达唑,剂量为 10mg/kg/天,每日分两次服用 3-6 个月,也被认为是整体治疗策略的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abe3/10484271/04e1ed229986/ajtmh.23-0267f1.jpg

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