1. Insect repellent treatment
Benzimidazoles: They are broad-spectrum nematode repellents. Albendazole 400mg, taken in one dose. Mebendazole is a C-type crystalline particulate agent, taken 500mg once. Ascaris lumbricoides can be eliminated within 2-4 days. The therapeutic effect is above 90%, and generally there are no side effects.
Benzimidazole compounds are key anti hydatid drugs studied in recent years, and have achieved certain therapeutic effects in clinical trials. Medication treatment can alleviate symptoms and prolong survival for patients with widespread dissemination and difficulty in surgery; As an auxiliary treatment before and after surgery, medication can also reduce the recurrence rate and improve the therapeutic effect. According to WHO recommendations, albendazole and mebendazole (mebendazole) are both listed as the preferred drugs for anti hydatid treatment.
Albendazole has good oral absorption and significant therapeutic effect, with a tendency to replace mebendazole. The dosage is 10-40mg/kg per day, taken twice, with a 30 day course of treatment. Depending on the condition, the treatment can be continued for several courses. Some people also suggest long-term high-dose albendazole treatment, with a daily dose of 20mg/kg. The course of treatment can range from 17 to 66 months (an average of 36 months). After long-term follow-up, the effective rate can reach 91.7%. Generally, patients can tolerate long-term treatment and have no serious toxic side effects. However, liver, kidney function, and bone marrow should be up during treatment, and pregnant women should avoid using it.
The dosage and course of treatment used in foreign countries for metronidazole vary, ranging from 20 to 200mg/(kg. d), usually ranging from 40 to 50mg/(kg. d). It is recommended to take it orally in three doses, with a course of one month. Generally, three courses of treatment are required, with an interval of half a month between them. There are also people who extend treatment to 3-5 years, and the efficacy reports are inconsistent. This drug has poor absorption, with only 1% absorption when taken orally on an empty stomach. Combined with a fat meal, the absorption rate can be increased to 5% -20%
Thiadiazine: a broad-spectrum nematode repellent. 500mg for adults, taken once. Children take 10mg/kg once a time. Pregnant women, liver, kidney, and heart disease patients are temporarily suspended from medication.
Piperazine: It has anticholinergic effects, causing muscle paralysis in the insect body. 3g for adults, 80-100mg/kg for children, taken on an empty stomach or once at night for 2 consecutive days. Patients with liver and kidney diseases and epilepsy are prohibited from taking medication. The one-time cure rate is 70% to 80%.
Levamisole: 150-200mg for adults, taken once. Occasionally causing toxic encephalopathy, should be used with caution.
2. Treatment of biliary ascariasis
The principle is to relieve spasms and pain, and to repel insects and resist infections in the early stage. Atropine 0.5mg and promethazine 25mg, intramuscular injection or intravenous drip. Most roundworms withdraw from the biliary tract. Insecticides can be treated orally with albendazole or mebendazole. Fever patients should be appropriately treated with anti infective drugs. ERCP has diagnostic and pest removal effects. Patients with concurrent acute suppurative cholangitis, liver abscess, and hemorrhagic necrotizing pancreatitis require surgical treatment.
3. Ascaris intestinal obstruction
Fasting, gastrointestinal decompression, spasmolysis and pain relief, fluid replacement, correction of dehydration and acidosis, and taking 60ml of soybean oil and peanut oil have the effect of relieving roundworm infestations. After relieving abdominal pain, expel insects. Patients with concurrent intestinal necrosis, perforation, peritonitis, and complete intestinal obstruction should undergo surgery in a timely manner.