超声引导下无水乙醇硬化治疗老年及老年前期肝囊肿的临床研究

目的:探讨超声引导下无水乙醇治疗老年及老年前期不同直径的肝囊肿的疗效和安全性。方法:收集本院2006年1月至2011年1月收治的老年及老年前期肝囊肿患者121例,所有患者均采用超声引导下经皮肝囊肿穿刺联合无水乙醇治疗;根据囊肿直径大小分为4组:A组(4～5cm)14例,B组(5.1～8cm)65例,C组(8.1～10cm)23例,D组(>10cm)19例,比较各组的疗效差异,记录术后不良反应发生情况,术后分别随访3～6个月以及1年。结果:本研究共治疗囊肿179个,A组治疗23个的治愈率为91.3%,显效率8.7%,总有效100%,其治愈率明显高于其它各组(P<0.05);B组治疗105个的治愈率为83.8%,有效率10.5%,总有效率94.3%;C组治疗30个的治愈率为76.7%,有效率13.3%,总有效率90%,与B组比较,治愈率和有效率无统计学差异(P>0.05);D组治疗21个的治愈率为42.9%,有效率38.1%,总有效率81.0%,其治愈率明显低于其它各组(P<0.05)。不良反应中疼痛、恶心、呕吐、腹胀最常见;少数患者可出现发热、醉酒样症状以及肝功能异常;囊肿直径越大,出血等并发症发生率越高。结论:超声引导下无水乙醇硬化治疗肝囊肿疗效肯定,方法安全、简便、并发症少,患者耐受性好,是治疗老年及老年前期肝囊肿的理想方法。

Study on effect of ultrasound guided anhydrous ethanol interposing puncture for liver cysts in the senium and presenium

AIM: To discuss the curative effect and security of ultrasound guided anhydrous ethanol interposing puncture for senium and presenium with different diameter of the cysts.METHODS: From January 2006 to January 2011,121 patients with senium and presenium liver cysts were evaluated and treated at our institution.All patients were treated with ultrasound guided anhydrous ethanol interposing puncture for liver cysts.According to the different diameter,all cases were divided into four groups: group A(4-5 cm) in 14 cases,B group(5.1-8 cm) in 65 cases,group C(8.1-10 cm) in 23 cases,group D(>10 cm) in 19 cases,retrospective analysis and postoperative complications were made in the groups.179 liver cysts were identified and treated,followed up three to six months and one year to observe the efficacy.RESULTS:23 lesions with group A were treated which was underwent with 91.3% curative rate,8.7% markedly effective rate and 100% curative effect.The obvious effect rate was significantly higher than that of other groups(P<0.05);105 lesions with Group B were treated which was underwent with 83.8% curative rate,10.5% markedly effective rate and 94.3% curative effect.30 lesions with Group C were treated which was underwent with 76.7% curative rate,13.3% markedly effective rate and 90% curative effect,and the obvious effect rate was not significantly different compared with group B(P>0.05);21 lesions with Group D were treated which was underwent with 42.9% curative rate,38.1% markedly effective rate and 81.0% curative effect.The obvious effect rate was significantly lower than that of other groups(P<0.05).The most common complications was pain,nausea,vomiting,abdominal distension;a few patients presented with fever,drunk like symptoms and abnormal liver function and the higher incidence of bleeding with larger cysts. CONCLUSION: This method might be reliable,safe,convenient,less complicate.It should be effective in the senium and presenium and worth to be used.