超声引导下穿刺注射乙醇治疗肾盂旁囊肿

目的 总结超声引导下穿刺治疗肾盂旁囊肿的经验体会,探讨其临床效果。方法 对169例肾盂旁囊肿患者行超声引导下穿刺注射乙醇治疗。其中囊肿压迫致肾积水36例（21．3％）,合并肾结石8例（4．7％）,全部经B超和静脉肾盂造影（IVP）检查,59例行cT检查。诊断明确后行经皮肾穿刺,穿出囊液立即行尿胺试验,对尿胺试验阴性者,以及尿胺阳性但囊肿造影确定与肾盂不相通者,用95％乙醇进行硬化治疗。自穿刺后1,3,6个月和1年时复查B超观察囊肿大小,以后每年随访1次。随访时间为6个月至5年。结果 囊肿治愈165例（97．6％）,囊肿缩小至≤1．5cm4例（2．4％）。36例肾积水全部缓解;8例肾结石,4例行体外冲击波碎石术（ESWL）后结石排出,2例行经皮肾镜取石,2例结石未治疗。穿刺后出现肉眼血尿5例,3～5d自行消失。结论 超声引导下经皮穿刺治疗肾盂旁囊肿,具有安全、有效、微创、合并症少等优点。

Ultrasound guided percutaneous puncture and sclerotherapy with alcohol for peripelvic cysts

OBJECTIVE: To summarize the experience of ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts and investigate the clinical effect. METHODS: A total of 169 cases of peripelvic cyst patients were evaluated, of whom 36 cases (21.3%) had hydronephrosis secondary to peripelvic cysts, 8 cases (4.7%) had renal calculus. All patients underwent ultrasound and intravenous phelography (IVP) examination, 59 patients also had CT scan. Hydatid fluid was analyzed by amine test. Percutaneous aspiration was guided by ultrasound, 95% alcohol was used to sclerosis the peripelvic cysts when amine test was negative or positive but did not have communication with pelvis through opacification. Ultrasound were done at 1, 3, 6 months and every 1 year thereafter, follow-up period were 6 months to 5 years. RESULTS: One hundred and sixty-five peripelvic cysts (97.6%) were cured by once sclerotherapy, the diameter of another 4 cases (2.4%) diminished to less than 1.5 cm by once sclerotherapy. Thirty-six cases of hydronephrosis were all resolved after sclerotherapy. Eight cases had renal calculus, of whom 4 cases underwent extracorporeal shockwave lithotripsy, 2 cases underwent percutaneous nephrolithotomy, and 2 cases did not treat the stone. Five patients had gross hematuria after aspiration, but all diminished in 3-5 d. CONCLUSION: Ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts had the superiority of safety, effectiveness micro-invasion and low complication.