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脊柱棘球蚴病致截瘫。手术引流联合甲苯咪唑治疗:一例报告

Hydatid disease of the spine causing paraplegia. The combined treatment by surgical drainage and mebendazole: a case report.

作者信息

Porat S, Robin G C, Wertheim G

出版信息

Spine (Phila Pa 1976). 1984 Sep;9(6):648-53. doi: 10.1097/00007632-198409000-00018.

Abstract

Hydatid disease of the spine is a rare disease with a poor prognosis. Paraplegia is a severe complication and has a low chance for recovery. Surgical drainage and decompression has been the treatment of choice although success was limited. Medical treatment with mebendazole was introduced in 1977 for cystic and alveolar Hydatid disease of the liver. In this paper, a case with Hydatid disease with complete paraplegia is presented. He was treated by combined surgical and medical treatment that included several surgical drainages, decompression, and fusion procedures, accompanied by high dose mebendazole for three years. Recovery from the paraplegia was complete except for the persistence of a neurogenic bladder. Neither clinical nor laboratory evidence of activity of the disease existed after six years of follow-up. This case must encourage further clinical trials in such cases, combining surgical treatment with mebendazole.

摘要

脊柱包虫病是一种罕见疾病,预后较差。截瘫是一种严重并发症,恢复机会低。手术引流和减压一直是首选治疗方法,尽管成功率有限。1977年开始使用甲苯咪唑对肝囊性和肺泡性包虫病进行药物治疗。本文报告了一例患有完全性截瘫的包虫病病例。该患者接受了手术和药物联合治疗,包括多次手术引流、减压和融合手术,并辅以大剂量甲苯咪唑治疗三年。除神经源性膀胱持续存在外,截瘫已完全恢复。随访六年,既无该疾病活动的临床证据,也无实验室证据。该病例必定会促使对此类病例开展进一步临床试验,将手术治疗与甲苯咪唑相结合。

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