前列腺苗勒管囊肿经直肠穿刺抽吸与硬化治疗

目的:比较经直肠超声引导穿刺苗勒管囊肿单纯抽吸与硬化治疗疗效。方法:勒管囊肿患者44例,采用经直肠超声检查及经直肠超声引导穿刺进行硬化治疗,21例进行无水乙醇硬化(治疗组),抽尽囊液后注入抽出囊液量1/2量的无水乙醇,保留5 min后抽尽残液;23例进行单纯的抽吸,抽尽囊液(对照组),经随访比较两组临床疗效。结果:两组患者治疗后均无明显不良反应发生,治疗组有效率80.95%,治愈率52.38%,对照组有效率56.52%,治愈率26.09%。两组比较疗效差异有统计学意义(P<0.01)。结论:采用经直肠超声引导穿刺无水乙醇硬化治疗苗勒管囊肿其过程安全,疗效确切,不易复发,为治疗前列腺苗勒管囊肿可取方法。     

前列腺苗勒管囊肿经直肠穿刺抽吸与硬化治疗

目的:比较经直肠超声引导穿刺苗勒管囊肿单纯抽吸与硬化治疗疗效. 方法:勒管囊肿患者44例,采用经直肠超声检查及经直肠超声引导穿刺进行硬化治疗,21例进行无水乙醇硬化(治疗组),抽尽囊液后注入抽出囊液量1/2量的无水乙醇,保留5min后抽尽残液;23例进行单纯的抽吸,抽尽囊液(对照组),经随访比较两组临床疗效. 结果:两组患者治疗后均无明显不良反应发生,治疗组有效率80.95％,治愈率52.38％,对照组有效率56.52％,治愈率26.09％.两组比较疗效差异有统计学意义(P＜0.01). 结论:采用经直肠超声引导穿刺无水乙醇硬化治疗苗勒管囊肿其过程安全,疗效确切,不易复发,为治疗前列腺苗勒管囊肿可取方法.     

改进后的肾囊肿CT引导下硬化剂治疗术

目的观察改进肾囊肿CT引导下硬化剂治疗术的疗效。方法386例肾囊肿经皮穿刺抽吸乙醇治疗,其中,单纯性肾囊肿243例,多发囊肿113例,双肾均有囊肿30例。囊肿直径1.5~7 cm。用9-14 G穿刺针穿刺抽吸,抽出囊液5~700 ml,注入99.7%无水乙醇保留而不抽出,乙醇量以抽出量的25%~50%计算。结果随访193例(251个囊肿),时间3个月~12个月,囊肿治疗有效率达98%以上,囊腔消失率达87%,并发症仅为局部腰部胀痛,无严重后遗症。结论改进后的CT引导下肾囊肿硬化剂治疗术是一种安全、并发症少,操作简单的有效治疗方法。     

经皮穿刺抽吸硬化治疗肝囊肿

目的探讨经皮穿刺抽吸硬化治疗肝囊肿治疗方法及疗效。方法回顾分析我院经皮穿刺抽吸硬化治疗肝囊肿28例临床资料。结果全组硬化治疗均获成功,在超声(20例)或CT(8例)引导下,28例患者共治疗36较大个囊腔,随访6个月～13年。疗效指数无0级病例,Ⅰ级为2个囊肿,Ⅱ级为19个囊肿,Ⅲ级为15个囊肿,其中囊腔消失5个。结论超声或CT引导下经皮穿刺抽吸硬化治疗肝囊肿是一种相对安全、有效的方法。     

超声引导下经皮穿刺无水乙醇硬化治疗甲状腺囊性病变

目的 探讨超声引导下经皮穿刺无水乙醇硬化治疗甲状腺囊性病变的临床价值.方法 对108例甲状腺囊性病变患者共126个病灶,包括56个甲状腺单纯性囊肿(单纯性囊性病变)及70个甲状腺结节或腺瘤出血或液化所形成的继发性囊性病变(复杂性囊性病变),于彩色高频超声引导下徒手经皮穿刺进行囊液抽吸及囊内注射无水乙醇硬化治疗;术后超声随访1年,评价其疗效.结果 总有效率97.62％(123/126),治愈率96.03％(121/126);术后3个月,单纯性囊性病变与复杂性囊性病变的有效率及治愈率差异均无统计学意义(P均＞0.05).未出现明显并发症.结论 超声引导下经皮穿刺无水乙醇硬化治疗甲状腺囊性病变疗效确切,安全可靠,且操作简便,不良反应少,可作为治疗良性甲状腺囊性病变的首选方法.     

酒精硬化疗法治疗非寄生虫性肝囊肿

非寄生虫性肝囊肿多为先天性且认为是胚胎发育畸形所致.症状通常出现于儿童期,肝肿大,囊肿内压力增加或对周围器官的压迫.少见肝功损害.单纯抽吸囊液的保守治疗复发率甚高.为了试验穿刺抽液后注入硬化剂是否可以避免囊肿复发,作者采用CT引导的经皮穿刺减压和无水酒精硬化疗法治疗一组非     

直肠超声下前列腺囊肿置管硬化治疗探讨

目的　探讨直肠超声引导穿刺并置管在前列腺囊肿硬化治疗中的应用。　方法　在直肠超声引导下 ,对前列腺囊肿进行穿刺置管 ,抽尽囊液、冲洗囊腔、注入无水酒精。　结果　 2 1例均成功置管并进行硬化治疗。随访 6月～ 18个月 ,2 1例囊肿均消失。　结论　直肠超声引导穿刺前列腺囊肿准确可靠 ,置管硬化治疗方便、安全、有效     

CT引导下经皮穿刺抽吸硬化治疗肝囊肿

目的 评价CT引导下经皮穿刺抽吸硬化治疗肝囊肿的临床价值。方法 36例肝囊肿患者，其中28例单发，8例多发。均在CT引导下经皮穿刺抽吸硬化治疗。结果 36例患者随访4～18个月，总有效率94％，未出现严重并发症。结论 CT引导下经皮穿刺抽吸硬化治疗肝囊肿简单易行，安全有效，治疗费用低廉。     

超声引导下经皮肝穿抽吸硬化介入治疗肝包虫囊肿

目的探讨超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿的应用价值。方法在超声引导下对38例肝包虫囊肿患者行经皮肝囊肿穿刺抽吸囊液,抽尽后向囊内注入20%～25%无菌高渗盐水或95%无水乙醇,注入量约为抽出量的25%～50%,保留5～15 min后全部抽出,再注入5～10 ml予以保留,术前术后结合口服抗包虫药阿苯达唑30～50mg/kg治疗。术后定期行超声随访,1年内3个月复查1次,1年后每年复查1次。结果治疗中1次穿刺成功率100%,6个月后16例囊肿缩小50%、22例缩小30%。1年后34例治愈,3例显效,1例好转。其后囊肿逐渐缩小,直至钙化,治愈率达100%。结论超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿是一种安全、有效、可靠的方法。     

超声引导置管大剂量无水乙醇硬化治疗巨大肝囊肿

目的探讨超声引导下置管大剂量无水乙醇硬化治疗巨大肝囊肿的疗效和安全性。方法 2001年5月～2011年5月,巨大肝囊肿24例,均为单发囊肿,直径102～180 mm,先在超声引导下穿刺囊肿并置入引流管,通过引流管抽尽囊液,使用大剂量无水乙醇注入囊腔硬化治疗,再用生理盐水冲洗囊腔,保留导管引流4～7天。结果治疗后3、6个月囊肿缩小率分别为(68.8±13.2)%、(86.3±12.4)%,术后12个月24例囊肿均完全消失,囊肿治愈率100%(24/24)。囊肿消失后随访2～5年,平均3年,无复发。结论该方法治疗巨大肝囊肿安全、微创,效果确切。     

CT引导改良平头针行肾囊肿穿刺及硬化剂治疗临床研究

目的：探讨应用改良平头针在CT引导下行肾囊肿穿刺及硬化剂治疗的方法及疗效。方法：使用带锐角针芯的去斜面18—21G穿刺针或16号肾活检穿刺针（即平头针面）在CT引导下对38例42个直径3．0～17.2cm的单纯性肾囊肿经皮穿刺抽吸,并行99．7％无水乙醇硬化剂治疗。结果：42个囊肿治疗后,随访3个月～1年。32个囊肿消失。7个囊肿缩小,无严重并发症,总有效率达92．9％（39／42）;临床症状缓解率为86．2％（25,／29）。结论：在CT引导下,用带针芯的改良平头针经皮穿刺及硬化剂治疗单纯性肾囊肿定位准确、创伤轻微、安全有效、简便易行,临床值得推广。     

彩色多普勒超声引导介入治疗肾囊性病变387例

目的：总结彩色多普勒超声引导下介入治疗肾囊性病变的远期疗效。探讨彩色多普勒超声引导下介入穿刺治疗肾囊性病变的穿刺要点。方法：对387例良性肾囊性病变（其中单纯性肾囊肿291例、多囊肾96例）,其中男229例,女158例,年龄11岁～91岁,平均48.6岁。囊肿直径最大143mm×129mm,最小32mm×30mm。对387例良性肾囊性病变采用实时彩色多普勒超声引导穿刺硬化治疗,对直径〉80mm及囊内感染者治疗后保留导管持续引流。结果：单纯性肾囊肿中77例治疗后随访2年,214例随访6个月,266例囊肿完全消失、无复发;25例治疗后囊肿直径小于30mm,随访期内囊肿无明显增大。96例接受穿刺抽液硬化治疗多囊肾患者,治疗后随访6～24个月,肾功能得到不同程度改善或未继续恶化者70例,26例患者肾功能进行性下降。结论：实时超声引导可提高穿刺治疗肾囊肿的准确性,该法简便易行、创伤小、疗效可靠、并发症少,有较高的应用价值。     

Long-term results after percutaneous minimally invasive procedure treatment of symptomatic simple renal cysts

Objective: To assess the effectiveness and long-term results of two repeated ethanol injections in the treatment of symptomatic renal cysts. Methods: Sixty-eight patients 47to 75 years old with 77 large (6.3–14.8 cm; mean 8.62 cm)symptomatic cysts were included in this study. Of the 68patients, in 4 cases there were renal cysts associated with renal calculi. An 8FR Pigtail catheter was inserted into the cyst under ultrasound guidance followed by aspiration of cystic fluid. Two repeated ethanol 95% injections were performed every 24 hours. Patients were followed-up by ultrasonography for a period of 12–48 months (mean 30). Results: In two patients the cyst puncture was not feasible because of poor visualization of puncture site while in one patient there was communication of cystic cavity with the pelvocaliceal system. In these patients surgical resection of cysts was performed. Complete and partial regression rates were 57/68 (83.82%) and 8/68 (11.76%)respectively. In four patients with renal stones and renal cysts, extracorporeal shock wave lithotripsy (ESWL) was successfully executed 1 month after sclerotherapy. Conclusion: Our results suggest that percutaneous aspiration followed by two repeated ethanol injections is highly effective on reducing recurrence of simple renal cysts. This revised version was published online in September 2006 with corrections to the Cover Date.     

Percutaneous injection sclerotherapy with tetracycline hydrochloride in simple renal cysts

OBJECTIVES: Symptomatic simple renal cysts can be treated by combination of percutaneous aspiration and sclerotherapy. A number of sclerosing agents including glucose, phenol, iophendylate, polidocanol, minocycline and pantopaque have been used in the past to prevent reformation of cyst. In this study, tetracycline HCL solution is evaluated as a sclerosant for treatment of simple renal cysts. METHODS: Our study treated 76 cysts in 70 patients with symptomatic renal cysts. Aspiration and sclerotherapy was performed on 56 cysts, and 20 cysts aspirated without sclerotherapy as a control group. Treatment was performed under local anesthesia and punctured under ultrasound guidances with an 18-gauge needle. Tetracycline HCL (20%) was injected into the cystic cavity according to cyst diameter. All patients were followed up with an ultrasound examination at 3 months, 6 months, and then at yearly intervals. The reduction rate was estimated by a comparison of the volume of the cyst before and after treatment. A cyst reduction of 50% or greater in diamater was considered as a successful treatment. RESULTS: The average follow-up period was 9.8 months in the sclerotherapy group and 9.9 months in the control group. The success rate was 85.7% in the sclerotherapy group. There was a significant difference in the reduction rate of tetracycline HCL sclerotherapy group and control group. No major complications were encountered.     

影像引导下穿刺硬化术与腹腔镜下开窗引流术治疗非寄生虫性肝囊肿:Meta分析

目的采用Meta分析对比观察影像引导下穿刺硬化术与腹腔镜下开窗引流术治疗非寄生虫性肝囊肿的安全性和有效性。方法通过计算机检索PubMed、Web of Science、中国知网、维普、万方数据库及中国生物医学文献数据库,收集有关影像引导下穿刺硬化术及腹腔镜下开窗引流术治疗非寄生虫性肝囊肿的临床对照试验,检索时限为建库至2017年12月。严格按照纳入及排除标准筛选文献后,进行资料提取及质量评价。采用STATA 14.0统计分析软件进行Meta分析。结果最终纳入9篇文献,共659例患者。Meta分析结果显示,与腹腔镜下开窗引流术相比,影像引导下穿刺硬化术的手术时间[标准均数差(SMD)=-2.82,95%CI(-3.80,-1.83),P0.01]、患者住院时间[SMD=-1.89,95%CI(-2.54,-1.24),P0.01]均较短,且治疗费用[SMD=-28.77,95%CI(-36.89,-20.66),P0.01]较低,但复发率[比值比(OR)=2.04,95%CI(1.25,3.35),P0.01]较高。2种治疗方法术后并发症发生率差异无统计学意义[OR=0.68,95%CI(0.33,1.38),P=0.29]。结论影像引导下穿刺硬化术的安全性与腹腔镜下开窗引流术相似,虽术后复发率较高,但手术时间、患者住院时间更短,治疗费用更低,且更易于操作,适应范围更广。     

超声引导下无水乙醇硬化治疗伴有射精管梗阻症状的苗勒管囊肿

目的:评价经直肠超声引导下无水乙醇硬化治疗伴有射精管梗阻症状的苗勒管囊肿的安全性和有效性,探讨该方法的临床价值。方法:对3例伴有射精管梗阻症状的前列腺苗勒管囊肿行超声引导下20 G针穿刺无水乙醇硬化治疗,超声随访评价疗效。结果:治疗后6个月全部囊肿均消失,超声检查射精管梗阻解除,无严重并发症发生。结论:超声引导下的无水乙醇硬化治疗安全有效,可成为临床治疗伴有射精管梗阻症状的前列腺苗勒管囊肿的新方法。     

Comparison of single and multiple sessions of percutaneous sclerotherapy for simple renal cyst

OBJECTIVE: To compare the results of single and repeated percutaneous sclerotherapy in patients with simple renal cysts. PATIENTS AND METHODS: Eighty-two patients with simple renal cysts underwent needle aspiration andsclerotherapy under ultrasonographic guidance. Forty-two patients (group 1) underwent one session of sclerotherapy with 99% ethanol immediately after aspiration and 40 patients (group 2) underwent sclerotherapy at least twice. The patients were followed up using ultrasonography at 3-month intervals. The complete disappearance or a reduction of more than half in the diameter of the renal cyst was considered a successful treatment. RESULTS: The mean diameter of the renal cysts was not significantly different in group 1 (6.12 cm) and 2 (6.75 cm). There was complete or partial regression in eight (19%) and 16 (38%) in group 1, and in 29 (73%) and nine (23%) in group 2, respectively. The overall success rate was significantly better in group 2 (95%) than in group 1 (57%; P < 0.001). CONCLUSIONS: These results suggest that multiple sclerotherapy is better than a single injection of sclerosant for reducing the recurrence of simple renal cysts.     

B超引导下经皮穿刺注射四环素与无水乙醇治疗肾囊肿疗效比较

目的:观察比较B超引导下经皮穿刺注射四环素与无水乙醇治疗肾囊肿的疗效。方法:92例单纯性肾囊肿在B超引导下经皮穿刺抽液后,注入硬化剂,45例注射四环素(1组),47例注射无水乙醇(2组)。1个月和3个月复查B超并比较两组疗效及并发症。结果:四环素与无水乙醇在治疗肾囊肿疗效方面无明显差异,而在副反应与并发症方面,四环素组发生率明显低于无水乙醇组。结论:超声引导下经皮穿刺注射硬化剂治疗肾囊肿方法简便,疗效确切;四环素治疗肾囊肿具有和无水乙醇相似的疗效,且更为安全。     

B超引导下经皮穿刺加硬化剂治疗单纯肾囊肿两种方法的比较(附64例报告)

目的：探讨在B超引导下经皮穿刺加硬化剂治疗单纯肾囊肿的最佳方法。方法：A组30例，在B超引导下经皮穿刺肾囊肿内单次藻注95％无水乙醇；B组34例，经皮穿刺后肾囊肿内置管反复多次灌注95％无水乙醇，并比较两组的疗效。结果：64例肾囊肿患者均穿刺成功，A、B两组有效率均为100％。术后随访2年，A组肾囊肿治愈率为83%，B组肾囊肿治愈率为100％，经t检验，两组治愈率差异有统计学意义（P〈0．05）。结论：囊肿内置管多次灌注硬化剂治疗单纯肾囊肿疗效满意，值得推广。