Guérin B, L'Her P, Lenegre-Thourin I, Pitchit K, Wanda O, Vuth C, Vara O, Hay S
Service Cliniques, l'Hôpital CALMETTE de Phnom Penh, Cambodge.
Med Trop (Mars). 1995;55(1):37-40.
Amoebic liver abscess is a common disease in developing countries. Although therapy is now perfectly standardized, errors and inaccuracies are frequent in daily practice. A study was performed at the Calmette Hospital in Phnom Penh (Cambodia) to evaluate and improve this situation. Diagnostic criteria and the outcome of treatment with oral or parenteral metronidazole were analyzed in 38 patients presenting amoebic liver abscess. Hepatalgia was observed in 100% of cases. Hyperleukocytosis and enhancement of the sedimentation rate occurred in 95% of cases. Diagnosis was confirmed by ultrasonography. Serodiagnosis, given its high cost, was not indispensable. Metronidazole was of comparable effectiveness and tolerance (90%) whether administered by the oral or parenteral route. The parenteral route should be used only for patents presenting digestive intolerance. Drainage of the abscess is necessary in cases characterized by immediate complications, abscesses with diameters greater than 120 mm and absence of improvement after 5 days of treatment.
阿米巴肝脓肿是发展中国家的一种常见疾病。尽管目前治疗方法已完全标准化，但在日常实践中仍经常出现错误和不准确的情况。在金边（柬埔寨）的卡尔梅特医院进行了一项研究，以评估和改善这种状况。对38例患有阿米巴肝脓肿的患者分析了诊断标准以及口服或胃肠外给予甲硝唑的治疗结果。100%的病例观察到肝区疼痛。95%的病例出现白细胞增多和血沉加快。通过超声检查确诊。血清学诊断因其成本高，并非必不可少。口服或胃肠外给予甲硝唑的有效性和耐受性相当（90%）。胃肠外给药仅适用于有消化不耐受的患者。对于有立即出现并发症、脓肿直径大于120毫米以及治疗5天后无改善的病例，脓肿引流是必要的。
