Bhalla Virandera Pal, Paul Souvik, Klar Ernst
Department of Gastroenterology, Marengo Asia Hospital, Gurugram, India.
Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Raipur, India.
Visc Med. 2023 Oct;39(5):112-120. doi: 10.1159/000533807. Epub 2023 Sep 25.
Echinococcosis also known as hydatid disease is a zoonotic parasitic disease caused by a tapeworm. It has a worldwide distribution. For long, it was thought to be a problem of the poorly sanitized "third world" and not given the importance it deserved. However, its occurrence in countries like Australia and New Zealand and recently in countries in Central Europe has meant that it is included in a WHO list of neglected diseases, has recently been the subject of extensive epidemiological studies, and has been the recipient of increased research funding.
The diagnosis is still based on clinical presentation in an endemic area corroborated with typical findings on imaging which routinely include ultrasound and CT scan. Serological tests have been used in some centers to support the diagnosis. Treatment depends on the site of involvement and can vary from wait and watch to extensive radical surgical procedures. The common element of all treatments is the addition of albendazole which forms an essential cornerstone of all treatment protocols. Inspite having been used for a fairly long time, there is still no consensus on the dose, duration, and timing of therapy with albendazole.
Hydatid disease continues to be a significant global health problem inspite of a good understanding of its life cycle and rising standards of public sanitation. Though diagnosis is straightforward and not expensive, treatment can sometimes be complicated. The addition of albendazole to all treatment protocols is an important advance, but firm guidelines on duration of its use are still awaited.
棘球蚴病又称包虫病，是一种由绦虫引起的人畜共患寄生虫病，呈全球分布。长期以来，人们一直认为这是“第三世界”卫生条件差导致的问题，未得到应有的重视。然而，它在澳大利亚和新西兰等国以及最近在中欧国家的出现，意味着它已被列入世界卫生组织的被忽视疾病名单，最近成为广泛流行病学研究的对象，并获得了更多的研究资金。
诊断仍基于流行地区的临床表现，并结合影像学的典型表现，影像学检查通常包括超声和CT扫描。一些中心已使用血清学检测来辅助诊断。治疗取决于受累部位，范围从观察等待到广泛的根治性手术不等。所有治疗的共同要素是加用阿苯达唑，它构成了所有治疗方案的重要基石。尽管阿苯达唑已使用了相当长的时间，但在其治疗的剂量、疗程和时机方面仍未达成共识。
尽管对包虫病的生命周期有了较好的了解，且公共卫生标准不断提高，但包虫病仍是一个重大的全球健康问题。虽然诊断简单且费用不高，但治疗有时可能很复杂。在所有治疗方案中加用阿苯达唑是一项重要进展，但仍有待关于其使用疗程的确切指南。
