다음과 같은 처방이 있어서 minocycline이 항생제 이외의 쓰임에 대해서 찾아보게 되었다.
간낭종?
간낭종이란 간 실질 내에 얇은 막으로 이루어진 공간이 생겨 그 속에 액체가 들어 있는 형태로, 단순한 물혹이라고 생각하면 된다. 주변 막을 이루고 있는 조직은 매우 얇은 정상 조직이며, 내부에 고여 있는 것도 혈액이나 염증 산물이 아닌 정상 체액의 일종이다.
[네이버 지식백과] 간낭종 [hepatic cyst] (서울대학교병원 의학정보, 서울대학교병원)
치료
특별한 치료를 요하지 않는다. 증상이 없고 낭종 내 출혈, 감염 등의 합병증이 없는데 수술이나 경피적 배액술 등의 치료를 하는 경우, 오히려 치료 자체에 따르는 합병증이 더 문제가 되므로 불필요한 치료를 하지 않아야 한다. 치료가 필요한 경우 피부를 통해 관을 삽입하여 내부의 액체를 밖으로 빼내는 경피적 배액술을 우선적으로 고려하고, 이것으로 충분하지 않을 경우 수술적 절제를 시행해야 할 수도 있다.
[네이버 지식백과] 간낭종 [hepatic cyst] (서울대학교병원 의학정보, 서울대학교병원)
Simple hepatic cysts (SHC)
대부분 작고(<3 cm) 무증상임
통증과 붓기를 유발하여 삶의 질을 저하시킬 수 있음
증상이 있는 경우, 현재 진료 지침은 상대적으로 덜 침습적인 복강경을 이용한 cyst deroofing, percutaneous aspiration and sclerotherapy (PAS) 방법을 권장함 (vs open surgical management); Baseline characteristics of 764 patients treated for SHC in 34 studies에서의 cyst size는 3 cm보다는 큰 편
Percutaneous aspiration and sclerotherapy (PAS): minimally invasive percutaneous procedure in which ultrasound-guided drainage is combined with administrating a sclerosing agent, often ethanol.
경화제
- 95-99.9% 에탄올
- minocycline
- 고장성 식염수
Digestive diseases and sciences 39.11 (1994): 2503-2509.
Nine patients with 16 symptomatic nonneoplastic congenital hepatic cysts were treated prospectively by ultrasonically guided percutaneous minocycline hydrochloride injection, and the usefulness of this treatment was evaluated. Seven of the patients had multiple hepatic cysts, and two solitary cysts. All the patients were women, ranging in age from 36 to 81 years. After cystic fluid had been aspirated with a 21-gauge PTC needle, minocycline hydrochloride was injected into all the cysts. The minocycline hydrochloride was dissolved in saline at a concentration of 200 mg in 9 ml, and mixed with 1 ml of 2% mepivacaine hydrochloride. The total quantity of minocycline hydrochloride injected varied from 100 mg to 1200 mg per hepatic cyst, depending on its size. Total or subtotal regression of the cysts was observed in all patients during follow-up periods ranging from 15 to 35 months. Seven patients became symptom-free, one showed symptom reduction, and one showed no change in symptoms. Minor side effects, eg, transient abdominal pain, slight right shoulder pain, and temperature elevation, were noted in three patients respectively. On the basis of these results, we conclude that ultrasonically guided percutaneous minocycline hydrochloride injection is useful for the treatment of symptomatic hepatic cysts.
reference:
1) Yamada, Nobuo, et al. "Treatment of symptomatic hepatic cysts by percutaneous instillation of minocycline hydrochloride." Digestive diseases and sciences 39.11 (1994): 2503-2509.
2) Furumaya, Alicia, et al. "Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts." Hpb 23.1 (2021): 11-24.
3) 네이버지식백과
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