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肺包虫囊肿的当前管理

Current Management of Pulmonary Hydatid Cyst.

作者信息

Aydın Yener, Ali Bilal Ulaş, Dostbil Ayşenur

机构信息

Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye.

Department of Anesthesiology, Atatürk University Faculty of Medicine, Erzurum, Türkiye.

出版信息

Eurasian J Med. 2025 Feb 3;57(1):1-7. doi: 10.5152/eurasianjmed.2025.24761.

Abstract

Hydatid disease is a zoonotic infection caused by the larval stage of the Echinococcus granulosus worm, commonly found in developing countries. The lungs represent the second most commonly affected organ in both children and adults. The disease is more common in children than in adults, and the growth of hydatid cysts is more rapid in children than in adults. Diagnosing uncomplicated cases of hydatid cysts is generally straightforward clinically and radiologically. However, difficulties may arise in diagnosing complicated cysts. Surgery is the definitive treatment for pulmonary hydatid cysts. The surgical approach is contingent upon a number of factors, including the dimensions of the cyst, the integrity of its structure, whether it is solitary or multiple, unilateral or bilateral, and the extent of lung parenchyma destruction. In contrast to the liver, surgical treatment is promptly planned upon the diagnosis of a pulmonary hydatid cyst. The most effective surgical method is cystotomy and capitonnage while maintaining the integrity of the lung parenchyma to the greatest extent possible. Albendazole is the preferred medical treatment, but it is not recommended for intact cysts during the preoperative period due to its potential to weaken the cyst wall and cause rupture. Albendazole is administered to prevent postoperative recurrence and for treatment in cases where surgery is not feasible.

摘要

包虫病是一种由细粒棘球绦虫幼虫阶段引起的人畜共患感染病,常见于发展中国家。在儿童和成人中,肺部是第二常见的受累器官。该疾病在儿童中比在成人中更常见,且儿童的包虫囊肿生长速度比成人更快。临床上和放射学上,诊断单纯性包虫囊肿病例通常较为简单直接。然而,诊断复杂性囊肿可能会出现困难。手术是治疗肺包虫囊肿的决定性方法。手术方式取决于多种因素,包括囊肿的大小、结构完整性、是单发还是多发、单侧还是双侧以及肺实质破坏的程度。与肝脏不同,一旦诊断出肺包虫囊肿,应立即规划手术治疗。最有效的手术方法是囊肿切开缝合术,同时尽可能最大程度地保持肺实质的完整性。阿苯达唑是首选的药物治疗,但术前不建议用于完整囊肿,因为它可能会削弱囊肿壁并导致破裂。阿苯达唑用于预防术后复发以及在无法进行手术的情况下进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af33/12036369/172512292694/eajm-57-1-24761_f001.jpg

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