Manterola Carlos, Vial Manuel, Melo Angélica, Oberg Carlos, Fonseca Flery
Department of Surgery, Universidad de La Frontera, Casilla 54-D, Temuco, Chile.
World J Surg. 2006 Feb;30(2):227-32. doi: 10.1007/s00268-005-0215-6.
The adequate treatment for hydatidosis requires a knowledge of certain aspects related to the survival of infectious agents, especially protoscoleces. The aim of this study is to evaluate the viability of protoscoleces in human hepatic hydatid cysts in order to determine the prevalence of their fertility and to study the association with variables typical of the host and of the parasite.
A cross-sectional study was done in biological material (the fluid from human hepatic hydatid cysts). The viability criteria used were: ovoid form, invaginated scolices and intact calcareous corpuscles, the presence of vibrating movements, and the absence of "vital" staining. The cysts were grouped as univesicular cysts (UVC), multivesicular cysts (MVC) and abscessed cysts (LAHO). Fertility was defined as living protoscoleces in relation to the total number of protoscoleces. Descriptive statistics were for the calculation of the prevalence of fertility, analytical statistics for the comparison of groups, and a multivariate analysis for the examination of the association between cyst fertility and clinical variables.
A total of 163 cysts with a median diameter of 15 cm were studied in this way. Of these lesions, 79 (48.5%) were UVC, 54 (33.1%) MVC, and 30 (18.4%) LAHO. On 99 occasions (60.7%), macroscopic communication was evident in the bile duct, and a prevalence of general fertility of 57.1% (94.4% for MVC, 53.2% for UVC, and 0% for LAHO, with a value of P<0.001). Association with location, type, and diameter of the cyst, and presence of biliary communications was verified by applying a bivariate analysis, and association between fertility and the variables of the type of the cyst and the existence of biliary communications was verified employing a multivariate analysis (P values of 0.004 and <0.001, respectively).
The prevalence of fertility found was low. The main prevalence of fertility was observed in MVCs. Fertility is associated with the type of cyst and the presence of biliary communications.
包虫病的恰当治疗需要了解与感染因子（尤其是原头节）存活相关的某些方面。本研究的目的是评估人肝包虫囊肿中原头节的活力，以确定其可育性的患病率，并研究与宿主和寄生虫典型变量的关联。
对生物材料（人肝包虫囊肿的囊液）进行了横断面研究。所使用的活力标准为：卵形形态、内陷的头节和完整的石灰小体、存在颤动运动以及不存在“活性”染色。囊肿分为单房囊肿（UVC）、多房囊肿（MVC）和脓肿性囊肿（LAHO）。可育性定义为存活原头节数量与原头节总数的关系。描述性统计用于计算可育性患病率，分析性统计用于组间比较，多变量分析用于检查囊肿可育性与临床变量之间的关联。
以这种方式共研究了163个囊肿，中位直径为15厘米。在这些病变中，79个（48.5%）为UVC，54个（33.1%）为MVC，30个（18.4%）为LAHO。在99例（60.7%）中，胆管存在明显的宏观连通，总体可育性患病率为57.1%（MVC为94.4%，UVC为53.2%，LAHO为0%，P值<0.001）。通过双变量分析验证了与囊肿位置、类型和直径以及胆管连通情况的关联，通过多变量分析验证了可育性与囊肿类型变量和胆管连通情况之间的关联（P值分别为0.004和<0.001）。
所发现的可育性患病率较低。可育性主要见于多房囊肿。可育性与囊肿类型和胆管连通情况有关。
