OBJECTIVE:To assess the therapeutic effects of long-term albendazole therapy in intraabdominal cystic echinococcosis.METHODS:Fifteen patients with a total of 45 cysts were treated with albendazole with dosage regimen of 20 mg.kg-1.d-1 for an average of 2.5 years. Repeated CT and ultrasound scannings (US) were performed after the end of therapy. The duration of follow-up was 3.6 years on average. The number, size and morphology of cysts were compared before and after treatment.RESULTS:The hydatid cysts were classified according to location and CT patterns into hepatic simple cysts, hepatic cysts with daughter cysts, hepatic/abdominal cysts and splenic cysts. The hepatic simple cysts responded most favorably to albendazole therapy, with an overall cure rate of 88.7%. The disappearance of cysts was observed in 43.0% of cases (15/35). Sixteen cysts (45.7%) became solidified or calcified, among which 8 cysts were completely calcified, 6 showed egg shell-like calcification of the cystic walls, and 2 showed solidification and calcification of cyst contents. Four patients had large hepatic cysts containing daughter cysts; the daughter cysts all disappeared after treatment, but one patient relapsed with the reappearance of daughter cysts at 4-year follow-up. Two splenic cysts also calcified. Two patients had peritoneal cysts; one calcified and the other one reduced in size. Among 15 patients treated, 9 were cured and 6 were improved. There was no serious toxic reactions with continuous long-term therapy in a small series of patients.CONCLUSIONS:Continuous long-term albendazole treatment of intraabdominal cystic echinococcosis is safe and effective in the treatment of hepatic simple cysts, and some daughter cysts, peritoneal secondary cysts and splenic cysts. No serious toxic reactions were found.
目的分析21例肝泡型包虫病的CT征象,评价阿苯达唑治疗效果。方法全部病例包虫抗原皮试、血清酶联免疫吸附试验(ELISA)与包虫免疫印迹试验(Westernbloting,WB)检测均为阳性,全部做CT扫描检查。阿苯达唑治疗后CT随访20例。结果CT表现最常见特征为轮廓不规则,边界不清,密度不均的以低密度区为主的混合密度灶(CT值:-25~+40HU),病灶区出现多少不一的钙化(CT值:+90~+556HU)是本病突出的表现。CT影像分三型:实质型7例;假囊型6例;混合型8例。3例增强CT中2例病灶无强化,1例病灶周边呈轻度环形强化。CT随访20例(时间1~9年,平均3.9年)中4例治愈,5例好转,5例稳定,6例恶化。结论CT扫描不但可用作肝泡型包虫病的诊断,而且可用于阿苯达唑等药物的疗效观察。