盆腔淋巴囊肿超声引导下不同介入治疗方法疗效分析

目的探讨超声引导下不同介入治疗方式对有症状性盆腔淋巴囊肿的疗效。 方法分析2014年6月至2020年6月解放军总医院收治的36例盆腔恶性肿瘤术后出现有症状性淋巴囊肿患者的超声引导下介入治疗情况，按照治疗方式不同分为单纯穿刺抽液组、无水乙醇硬化组和置管引流组，采用χ²检验比较3种治疗方式的疗效差异。 结果单纯穿刺抽液组患者11例，治愈率为36%（4/11），对于合并感染的较小淋巴囊肿（＜5 cm），单纯抽液+抗生素冲洗有效，1例淋巴囊肿直径＞10 cm者效果为无效；无水乙醇硬化组患者13例，治愈率为62%（8/13），2例淋巴囊肿直径＞10 cm者效果为无效；置管引流组患者12例，治愈率为83%（10/12），淋巴囊肿直径＞10 cm的病例均为治愈和好转。置管引流组治疗效果优于无水乙醇硬化组，无水乙醇硬化组治疗效果优于单纯穿刺抽液组，3组间差异具有统计学意义（χ²=12.91，P=0.012）。36例患者均治疗成功，无术后并发症发生。 结论超声引导下介入治疗淋巴囊肿安全有效。超声引导下置管引流治疗效果最佳，尤其是对较大囊肿；无水乙醇腔内硬化治疗治愈率较高；单纯抽液治疗疗效较差，而伴有感染的淋巴囊肿穿刺抽液并抗生素冲洗留置疗效良好。

Therapeutic efficacy of ultrasound-guided interventional therapy for postoperative pelvic lymphocysts

ObjectiveTo assess the therapeutic efficacy of different ultrasound-guided interventions in the treatment of pelvic lymphocysts. MethodsThe data of 36 patients who underwent ultrasound-guided intervention treatment of pelvic lymphocysts after gynecologic carcinoma at the PLA General Hospital from June 2014 to June 2020 were retrospectively analyzed. Ultrasound-guided aspiration, absolute alcohol sclerotherapy, or catheter drainage was utilized in the treatment, and Chi-square tests were conducted to compare the effectiveness rate among different treatments. ResultsThe effectiveness rate was 36% (4/11) for ultrasound-guided aspiration, which was effective for the lymphocysts with a size of less than 5 cm with the combined treatment of aspiration and antibiotic indwelling, 62% (8/13) for ultrasound-guided absolute alcohol sclerotherapy, and 83% (10/12) for ultrasound-guided catheter drainage. For the pelvic lymphocysts with a diameter of >10 cm, ultrasound-guided aspiration was ineffective in one case, ultrasound-guided absolute alcohol sclerotherapy was ineffective in two cases, but ultrasound-guided catheter drainage was effective for all the cases. The effectiveness of ultrasound-guided absolute alcohol sclerotherapy was better than that of ultrasound-guided aspiration, and the effectiveness of ultrasound-guided catheter drainage was better than that of ultrasound-guided absolate alcohol sclerotherapy; there was a statistical difference among the three groups (χ²=12.91, P=0.012). ConclusionUltrasound-guided intervention therapy is safe and effective in the treatment of postoperative pelvic lymphocysts. Among the three ultrasound-guided interventional therapies, ultrasound-guided catheter drainage has the best therapeutic efficacy, especially for larger size lymphocysts, and ultrasound-guided aspiration has the worst effectiveness, though it is effective for smaller size lymphocysts anyway.