阿苯达唑治疗中小学生棘球蚴病的观察

目的观察阿苯达唑乳剂给药方案治疗儿童棘球蚴病的依从性、副反应及疗效,为进一步完善棘球蚴病治疗方案提供依据。方法在校儿童进行B超结合血清学检查,对病灶最大径≥1cm的棘球蚴病病例给予阿苯达唑乳剂治疗。每人每天口服阿苯达唑乳剂12.5mg/kg,连服3个月为1个疗程,观察期1年最多完成4个疗程。随访服药和副反应发生情况。开始治疗的1年后B超复查考核疗效,采用χ^2检验、多元logistic回归等方法综合评价疗效及其影响因素。结果共治疗儿童棘球蚴病临床诊断患者160例,治疗期间总不良反应发生率为15.0%。160例中,连服2-4个疗程者占66.2%（106/160）;连续服药不足2个疗程者占33.8%（54/160）。完成2-4个疗程的细粒棘球蚴病和多房棘球蚴病的治愈率、有效率分别为0、27.9%和0、58.7%。细粒棘球蚴病不同疗程组间疗效存在显著性差异（χ^2=6.09,P〈0.05）;多房棘球蚴病不同疗程组间疗效无显著性差异（χ^2=0.07,P〉0.05）。多元logistic回归分析显示,治疗疗程和病灶大小是影响治疗效果的主要因素。结论阿苯达唑乳剂治疗儿童棘球蚴病疗效较低,提示阿苯达唑乳剂治疗儿童棘球蚴病的合理剂量、疗程有待进一步研究改进。在治疗方案实施中密切观察与处理不良反应、定期随访、进行健康教育以提高对棘球蚴病长疗程治疗的依从性很有必要。

Clinical observation of albendazole to treat echinococcosis in children

Objectives To observe the efficacy of using albendazole to treat echinococcosis in children and to ascertain their compliance with that treatment. Methods School-aged children underwent ultrasound and a blood test.Children with lesions no larger than 1cm in size were treated with albendazole.An albendazole emulsion was taken orally at a dosage of 12.5mg/kg per day for 3months consecutively in a single course of treatment.Children completed a maximum of 4courses of treatment.Compliance was determined and any adverse reactions were noted.Efficacy and related factors were evaluated one year later using ultrasound. Results In total,160 children who were clinically diagnosed with echinococcosis were treated,15% of whom had adverse reactions.Of the 160 children,66.2%（106/160）received 2-4courses of treatment while 33.8%（54/160）received fewer than 2courses.Two to 4courses of treatment cured cystic echinococcosis at a rate of 0% and those courses had an efficacy of 27.9%;2to 4courses cured alveolar echinococcosis at a rate of0% and those courses had an efficacy of 58.7%.There were significant differences in the efficacy with which 2-4courses of treatment and fewer than 2courses treated cystic echinococcosis while there were no significant differences in the efficacy with which 2-4courses of treatment and fewer than 2courses treated alveolar echinococcosis.The size of lesions and number of courses of treatment were two major factors that affected efficacy. Conclusion Albendazole administered in accordance with the regimen used in this study had a low level of efficacy in treating echinococcosis in children.This indicated the need to improve the dosage and courses of treatment.Adverse reactions must be closely observed and dealt with accordingly,periodic follow-ups must be conducted,and health education must be provided to increase compliance with echinococcosis treatment.