Hydatid disease should be how is it treated?
Surgery is the preferred method of cure of this disease, should seek to pressure operating before symptoms or complications. When patients first with a thin needle to take away the cyst fluid (beware of cystic fluid leak), and then excision of internal capsule. Internal capsule and external capsule with only mild adhesion, easy to peel, often can be removed complete. Lung, brain, bone and other parts of the surgical removal of hydatid disease should be OK.
In the surgical removal of hydatid cyst within the prior to the injection of hydatid cysts 10% formalin solution to help kill the former head larva, as the product of the lung tissue, stimulating and occasionally with side-effects of poisoning, it is not particularly apply to ruptured pulmonary or hepatic hydatid cyst.Abroad there have been using Xiqu bromide (cetrimide) to kill the former head larva, and considered to be of low toxicity with good effects to kill the former head larva ideal agent for human hydatid cyst excision before the injection capsule 2 times, an appropriate amount of 0.1 % Cetrimide, each lasting five minutes, a group of 10-year period 378 cases of surgery through the application and post-operative observation report shows that non-one cases of hydatid recurrence, without using Cetrimide ago, after hydatid recurrence rate was 10% .
Benzimidazoles at home and abroad in recent years, focus on the anti-hydatid drugs in animal experiments on the basis of clinical trial and achieved a certain effect. In accordance with WHO advice, albendazole and mebendazole are classified as drug of first choice of anti-hydatid. There authors believe that the indications are as follows: ① secondary abdominal or thoracic hydatid disease, mostly occurs in the primary liver or lung hydatid concurrent breakdown can also be a result of lax protection of hydatid surgery, or because mistaken for diagnostic puncture, resulting in hydatid cyst fluid leak, secondary cultivation spread of disease throughout the whole abdominal or thoracic surgery difficult to eradicate. ② multiple or multi-organ hydatid, or recurrent hydatid disease, the patient is unwilling or can not accept re-(multi) surgeries. ③ patients and the coexistence of old and infirm, or vital organs of the organic diseases, poor tolerance to surgery. ④ by surgical exploration or no cure for advanced liver alveolar hydatid disease, or secondary lung, brain metastasis, drug treatment can relieve symptoms and prolong survival. ⑤ either cystic or alveolar echinococcosis, chemotherapy as an adjuvant before and after surgery can reduce the recurrence rate and improve efficacy.
Zole can be reached after the advent of benzene in the treatment of echinococcosis have to replace the trend of mebendazole, albendazole absorption is better, its serum concentration 100 times higher than that mebendazole. Hydatid cyst fluid concentrations 60 times higher than that mebendazole. For the treatment of cystic echinococcosis, its daily dose of 10 ~ 40mg/kg, 2 times, serve 30 days for a course of treatment, visual condition for several consecutive treatments, which course of treatment is superior to mebendazole, especially in lung hydatid disease better. Alveolar echinococcosis of the country it was suggested that the long-term large doses of albendazole treatment, their daily dose of 20mg/kg, treatment from 17 months to 66 months (mean 36 months) range, after a long-term follow-up and found that CT scans showed significant progress, most of all cases of calcification of the original lesions were cured, the effective rate was 91.7%. Most patients can tolerate for long-term treatment, no serious side effects, but the governance process should follow in the liver, kidney function and bone marrow.Pregnant women hanged.
Mebendazole dose and treatment with different foreign countries. Doses ranging from 20 ~ 200mg/kg per day, usually 40 ~ 50mg/kg per day is appropriate, sub-3 second oral course of treatment in January, rest and a half months and then served another course of treatment, general treatment for 3 months.Also expressed that the treatment of cystic echinococcosis are required to drug 1 in June, while the treatment of alveolar echinococcosis Zexu extended course of treatment, a long time are up to 3 ~ 5 years. Reported mixed effects, some patients with cystic echinococcosis is expected to cure, the efficacy is superior to pulmonary hydatid disease of liver hydatid disease. Mebendazole absorption is poor, usually taking only a 1% absorption of fasting for the sake of improving efficacy, medication should be with the fat meal, absorption of drugs easier and fat together, reportedly associated with fatty meals can be served when the absorption rate of 5% ~ 20%.