Besim H, Karayalçin K, Hamamci O, Güngör C, Korkmaz A
6th Department of Surgery, Ankara Numune Hospital, Turkey.
HPB Surg. 1998;10(6):347-51. doi: 10.1155/1998/78170.
Injecting scolicidal solutions into the hydatid cyst and packing the operative field with sponges soaked in scolicidal agents have been used to avoid dissemination of the parasite during surgery. In the first part of this invitro study, we tried to determine the scolicidal property of various agents in different concentrations and exposure times. In the second part, we tested whether sponges soaked in different type and concentrations of scolicidal agents have any role beyond being a mechanical barrier. 20% saline, 3% hydrogen peroxide, 1.5% cetrimide-0.15% chlorhexidine (10% Savlon), 95% ethyl alcohol, 10% polyvinylpirrolidone-iodine (Betadine) and their further dilutions were used in this study. Protoscoleces were obtained from the cyst containing livers of the sheep and viability was determined with dye-uptake (0.1% Eosin) and flame cell activity. Savlon was found to be the least concentration dependent scolicidal agent among those studied. Scoleces sprayed on sponges soaked in 20% saline, 95% ethyl alcohol, Betadine and 3% hydrogen peroxide were killed after 15 minutes. 3% and 10% saline and normal saline were ineffective. Sponges work not only as a mechanical barrier but also as a chemical one if the agent is chosen correctly. In purely cystic hydatid liver disease, the risk of dissemination of the cyst contents can be avoided by injection of a potent scolicidal agent such as Savlon.
向包虫囊肿内注射杀头节剂，并使用浸泡有杀头节剂的海绵填充手术区域，已被用于避免手术期间寄生虫的传播。在这项体外研究的第一部分，我们试图确定不同浓度和暴露时间下各种药剂的杀头节特性。在第二部分中，我们测试了浸泡在不同类型和浓度杀头节剂中的海绵是否除了作为机械屏障之外还有其他作用。本研究使用了20%盐水、3%过氧化氢、1.5%西曲溴铵-0.15%氯己定（10%萨伏隆）、95%乙醇、10%聚维酮碘（碘伏）及其进一步稀释液。从感染包虫的绵羊肝脏囊肿中获取原头节，并通过染料摄取（0.1%伊红）和焰细胞活性测定其活力。在研究的药剂中，发现萨伏隆是杀头节作用最不依赖浓度的药剂。喷洒在浸泡于20%盐水、95%乙醇、碘伏和3%过氧化氢中的海绵上的原头节在15分钟后被杀死。3%和10%盐水以及生理盐水无效。如果选择正确的药剂，海绵不仅起机械屏障作用，还起化学屏障作用。在单纯性肝包虫囊肿疾病中，通过注射强效杀头节剂如萨伏隆，可以避免囊肿内容物播散的风险。
