B超引导下穿刺注射无水酒精治疗肝囊肿

本文总结了经B超引导下穿刺注射无水酒精治疗肝囊肿36例,其中男性21例,女性15例。年龄25—74岁。单发性囊肿28例,多发性囊肿8例。采用细针穿刺抽液注无水酒精治疗者26例,采用置管引流后注无水酒精治疗者10例。于1—6月内复查B超,多数囊腔闭合,仅少数残存极少的囊腔。在不具备穿刺     

CA-199在肝囊肿患者中的表达

目的:探讨血清及囊液中CA-199与肝囊肿的关系.方法:检测肝囊肿患者血清和囊液中CA-199浓度,对比经皮肝穿刺囊肿抽液并无水酒精注射前后血清中CA-199浓度变化.并分析其与囊腔直径、囊液量间的关系.结果:血清CA-199浓度升高的肝囊肿患者,经穿刺抽液并无水酒精注射后浓度明显下降[(51±3)U/mL vs (24±2)U/mL,P<0.05];血清CA-199浓度与肝囊肿囊腔直径及囊液量呈正相关.结论:血清CA-199有可能作为肝囊肿穿刺抽液并无水酒精硬化治疗后效果判断的指标之一.     

B型超声普通探头引导经皮肝穿刺无水酒精注射治疗非寄生虫性？…

１９８９年４月于１９９７年１０月我院采用超声普通探头引导下肝空刺抽吸囊液后注射无水酒精治疗晨寄生虫性肝囊肿１０２例，共１４７个囊肿病灶，其中多发性肝囊肿７２例，单发性肝囊肿３０例，最大囊肿直径２０．０ｃｍ，平均每例治疗３－４次，一次抽液量最多为１３７０ｍｌ，累计抽液量最多为４２７０ｍｌ，治疗结果，６９个囊肿治 ，７８个囊显著缩小，共治疗５０６次，未发生严重并发症。本法是有适应症广，创伤小，副作用少     

B型超声普通探头引导经皮肝穿刺无水酒精注射治疗非寄生虫性肝囊肿

１９８９年４月至１９９７年１０月我院采用超声普通探头引导下肝穿刺抽吸囊液后注射无水酒精治疗非寄生虫性肝囊肿１０２例，共１４７个囊肿病灶，其中多发性肝囊肿７２例，单发性肝囊肿３０例，最大囊肿直径２０．０ｃｍ，平均每例治疗３～４次，一次抽液量最多为１３７０ｍｌ，累计抽液量最多为４２７０ｍｌ，治疗结果：６９个囊肿治愈（占４６．９％），７８个囊肿显著缩小（占５３．１％），共治疗５０６次，未发生严重并发症。本法具有适应症广，创伤小，副作用少，疗效好，经济负担少，患者易于接受等优点     

经腹腔镜肝囊肿开窗术治疗症状性非寄生虫性肝囊肿

目的 探讨腹腔镜治疗非寄生虫性肝脏囊肿。方法 肝囊肿患者在腹腔镜下超声刀或电凝开窗，吸净囊液，冲洗囊肿腔。结果 36例术后症状全部消失。随访6—36个月，2例囊肿较大者有小囊肿残留。结论 腹腔镜是治疗非寄生虫性肝囊肿的微创外科有效方法。     

超声引导下注射无水酒精治疗单纯性肝囊肿的临床疗效分析

单纯性肝囊肿是一种常见的良性疾病,由胆管生长和发育障碍所致,囊壁衬以分泌液体的上皮细胞,囊腔内含清亮液体,若有腔内出血,则呈红褐色.传统的治疗方法是囊肿开窗术、囊肿或部分肝切除术等,创伤大、并发症多.2009年10月至2011年9月,采用超声引导下无水酒精硬化治疗单纯性肝囊肿,效果满意,现报道如下.     

改良式超声引导下无水酒精治疗腹内囊肿的探讨

目的 观察改良式无水酒精囊内注射，治疗肝肾等胰腺囊肿的效果和安全性。方法 在B超引导下对肝、肾、卵巢、胰腺等囊肿进行穿刺无水酒精凝固术，无论在穿刺部位及穿刺针大小的选择都根据其囊肿声像图上的透声性及粘稠度来决定。穿刺过程中仔细观察针尖是否在囊腔内，不要被空气进入囊腔，否则残留的空气可妨碍硬化剂与囊壁充分接触而导致囊肿复发，注入99％无水酒精的量应为抽出囊液的1／4∽1／5为宜，不转动体位，而是采用治疗后少量酒精置留囊内的方法。结果 58例囊肿凝固治疗，术后患者半个月至1个月第1次复查，所有病人与术前相比有不同程度缩小，3个月至1年半后复查囊肿完全消失。除1例在操作过程中出现剧烈腹痛，脸色潮红、出冷汗外，其他无不良反应和并发症。结论 超声引导下，无水酒精治疗肝肾卵巢胰腺囊肿是一种安全有效的方法，用少量酒精置留囊内可达到与转动体位相同的效果。     

超声引导下无水酒精置换疗法治疗肝、肾、卵巢巨大囊肿

目的采用无水酒精置换疗法,通过一次穿刺治疗过程,对巨大肝、肾及卵巢囊肿进行治疗,以达到治愈的目的.方法 36例肝、肾、卵巢巨大囊肿(直径>7 cm) ,用18 GEV穿刺导管针,在超声导引下行无水酒精置换术.结果 "置换疗法"治疗后一周复查,囊腔均明显回缩.囊腔在3个月内消失的有10例,4～5个月消失的12例,6个月消失的14例,1年后复查无1例原位复发.术后除部分患者出现一过性面颈部潮红呈醉酒貌(经大量饮水后均自行缓解)外,其余病例未见其他副反应及明显并发症.结论本文采用的"无水酒精置换疗法"治疗巨大肝、肾、卵巢囊肿,减少了穿刺的次数、缩短了病程、提高了疗效.     

B超引导下经皮穿刺无水酒精治疗肝囊肿13例

目的 :探讨无水酒精治疗肝囊肿的疗效。方法 :回顾分析 1994～ 2 0 0 1年B超引导下经皮穿刺无水酒精治疗13例肝囊肿的临床资料。结果 :13例肝囊肿经皮穿刺无水酒精多次治疗均痊愈。结论 :无水酒精治疗肝囊肿疗效确切。     

超声引导下硬化治疗单纯性肝囊肿研究现状

<正>肝囊肿是肝内一种良性囊性病变,在临床较为常见,可分为寄生虫性肝囊肿和非寄生虫性肝囊肿~([1])。寄生虫性肝囊肿最多见的是肝包虫病,非寄生虫性肝囊肿有先天性和后天性之分。单纯性肝囊肿(SHC)是先天性肝囊肿的一种,在临床多见。目前影像介入学发展迅速,技术逐渐创新,并在临床中得以推广应用,使该疾病的治疗取得了很大进展,现将超声引导下硬化治疗SHC的现状总结如下。     

超声引导经皮穿刺硬化治疗卵巢囊肿

目的：探索一种治疗卵巢囊肿的新方法。方法：对43例经临床观察确诊的卵巢囊肿,在超声引导和监视下穿刺注入无水乙醇法进行硬化治疗。结果：43例全部有效,32例一次治疗消失,2例二次治疗消失,6例三次治疗消失,3例四次治疗后明显缩小,发生并发症3例。观察最长36个月,最短6个月,平均21个月,未见复发。结论：超声引导穿刺硬化治疗卵巢囊肿是一种简便易行,创伤轻微,安全实用,疗效可靠的新方法。     

Hydatid liver cyst: an 11-year experience of treatment with percutaneous aspiration and ethanol injection.

OBJECTIVE: To report an 11-year experience of treatment of hydatid liver cysts with double percutaneous aspiration and injection of alcohol. METHODS: Of the 129 patients with 174 hydatid liver cysts admitted to our department between January 1988 and January 1999, 79 patients with 119 vital hydatid liver cysts were selected for double percutaneous aspiration and injection of alcohol. Under ultrasonographic guidance, cystic cavities were first drained through fine needles, and then 95% sterile ethanol was injected and left in situ. The same procedure was repeated 3 days later without reaspiration of the injected alcohol. General anesthesia without endotracheal intubation was performed in 21 selected cases. RESULTS: Double percutaneous aspiration and injection of alcohol was completed in 78 patients with 118 hydatid liver cysts. In 1 case the procedure could not be accomplished because of an intracystic hemorrhage. A total of 254 punctures were performed, and the ethanol injected per session ranged between 12 and 250 mL. The mean hospital stay was 2.9 days (range, 2-7 days). The overall median follow-up was 48 months (range, 6-122 months). At the last ultrasonographic examination, 45.8% of the treated hydatid liver cysts had a solid pattern, 47.4% were no longer appreciable, and 6.8% had a minimal liquid component. Intracystic relapse occurred in 5% of the patients. In no case were any new cysts observed either in different hepatic segments or in any extrahepatic location. The morbidity rate was 9%, and 1 death occurred (mortality rate, 1.3%). CONCLUSIONS: Over a long period, double percutaneous aspiration and injection of alcohol proved to be a substantially safe, effective, and low-cost procedure for hydatid liver cyst treatment.     

肝囊肿的超声介入治疗

作利用医用无水乙醇具有使细胞质脱水、凝固坏死的特性对20例肝囊肿进行了超声介入治疗．其中，男性7例．女性13例、平均年龄57岁。囊肿为20～150mm不等。经一或多次重复治疗后．随访3～6个月发现：8例肝囊肿彻底消失．12例肝囊肿有所缩小(P<0.01)。无水乙醇作用于囊肿内壁上皮细胞．使该细胞凝固坏死，失去其分泌功能．达到治疗目的。作认为．25％的替代容量最为理想，但最多不宜超过20ml，它既能与囊肿内壁的各个部份接触．又不致于产生过高的局部压力使乙醇外渗．无水乙醇的超声介入治疗是肝囊肿治疗中一个简便、实用且安全的方法．可替代传统的开放引流及外科手术切除．值得临床推广。     

磁共振增强扫描对颅后窝占位性病变 的诊断价值

目的 评价增强扫描对颅后窝占位性病变定性诊断及术后随访的价值。方法 回顾性分析38例颅后窝占位性病变的MRI平扫及增强表现。全部病例均经手术病理及临床证实,其中星形细胞瘤8例。髓骨细胞瘤3例。血管母细胞瘤4例。转移瘤5例,脑膜瘤9例,脑脓肿2例,表皮样囊肿3例。蛛网膜囊肿4例。结果 血管母细胞瘤呈大囊小结节型。壁结节显著均匀强化,囊壁囊液不强化;髓母细胞瘤实质强化较明显,内部囊变区较小;星形细胞瘤可呈实质性或囊实性,强化表现复杂;转移瘤及脑脓肿强化表现相似,可结合病史加以鉴别;脑膜瘤明显强化,并可显示：脑膜尾征“,表皮样囊肿和蛛网膜囊肿不强化,9例患者术后进行了11次复查,1例诊断肿瘤残留复发,8例可见不同程度的术后改变。结论 MRI增强扫描能对大多数颅后窝占位性病变进行定性诊断,对临床治疗及术后随访具有较高的指导意义。     

Latex agglutination test (LAT) for antigen detection in the cystic fluid for the diagnosis of cystic echinococcosis

Latex agglutination test (LAT) was standardized and evaluated to detect hydatid antigen in fluid samples aspirated from 6 surgically proved human cases of cystic echinococcosis (CE), 4 suspected human cases of CE (2 cases of cysts in the liver which were not confirmed surgically and 2 cases of pelvic cysts later confirmed as abscesses) and 7 cases of hydatid cysts of liver in cattle. Echinococcus granulosus scolices and hook lets were seen in aspirated fluid by microscopy and the characteristic germinal layer of the cyst wall was demonstrated by histopathology in 6 human hydatid cysts operated and removed by surgery. In case of cattle hydatid liver cysts no scolices or hook lets were seen in aspirated fluid as they were sterile cysts but characteristic laminated layer of the cyst wall was demonstrated by histopathology of these cysts. The LAT could detect antigen in fluid samples collected from all 6 human cases of surgically proved CE and 7 cases of hydatid cyst liver in cattle, thus showing sensitivity of 100%. The LAT could detect antigen in fluid samples collected from 2 suspected cases of CE liver in humans, which were not operated. The LAT was found to be specific.No cross reactivity was observed.The results of the study showed that LAT could be employed as a simple and rapid diagnostic procedure, as an alternate to microscopy, to confirm the hydatid etiology of a suspected cyst.     

CT引导下经皮穿刺肝囊肿及肾囊肿硬化剂治疗的疗效分析

目的探讨CT引导下经皮肝囊肿、肾囊肿硬化剂治疗的临床应用价值。方法51例(肝脏囊肿20例,肾脏囊肿31例)经CT扫描确诊为单纯性囊肿的患者,囊肿大小自2.8cm&#215;3.5cm&#215;5.3cm~9.8cm&#215;15.6cm&#215;16.8cm不等。在CT导向下应用穿刺抽吸针抽出囊液,并注射硬化剂无水乙醇治疗,硬化剂注射量约为抽出囊液的25%。术后分别于3个月及半年后各复查一次CT扫描。结果51例肝脏囊肿及肾脏囊肿均一次穿刺成功,有效率为100%。半年后复查见49例完全消失或明显缩小,2例有缓慢复发迹象。51例中,46例于术后3个月复查一次,且中33例于术后半年复查第二次,另外5例于半年后复查1次,均未见复发。结论CT引导下经皮肝囊肿及/或肾囊肿硬化剂治疗有较高临床应用价值,且方便、安全有效。     

超声引导介入治疗肝囊肿468例疗效评价

目的比较超声引导下无水乙醇的不同注射方法治疗肝囊肿的疗效。方法 468例肝囊肿患者,230例采用超声引导下囊肿穿刺抽液后注射无水乙醇治疗(传统组),238例采用超声引导下囊肿穿刺抽液后加无水乙醇灌洗治疗(灌洗组)。术后12个月内随访,观察疗效及并发症。结果 468例肝囊肿患者经无水乙醇治疗后12个月内复查,传统组治愈率为75.0%;灌洗组治愈率90.8%,两者之间有显著性差异(P<0.01)。两组>10.0cm肝囊肿治愈率无显著性差异(P>0.05),显效率有显著性差异(P<0.05)。结论超声引导下肝囊肿无水乙醇灌洗法是一种高疗效、疗程短、并发症少的方法。     

Complications after interventional sonography of focal liver lesions: a 22-year single-center experience.

OBJECTIVE: To analyze the complications of diagnostic and therapeutic sonographically guided interventional procedures of focal liver lesions observed during a 22-year period in a single center. METHODS: Complications of sonographically guided diagnostic and therapeutic procedures on focal liver lesions, observed during a 22-year period in a single center, were reviewed. From 1979 to 2001, 13,222 patients (age range, 7-89 years; mean, 59 years; 8,688 male and 4,534 female) with 13,777 focal liver lesions underwent 16,648 sonographically guided biopsies and 3,035 therapeutic procedures: pyogenic and amebic abscess aspiration, ethanol injection of hydatid liver cysts, and percutaneous ablative treatments (ethanol injection in either multiple or one-shot sessions, radio frequency ablation, and interstitial laser photocoagulation) of primary and secondary liver tumors. RESULTS: The overall mortality was 0.06%. No death or major complication occurred after diagnostic procedures and liver abscess drainage. In the therapeutic group mortality was 0.6%: 1 patient died of anaphylactic shock during treatment of a hydatid cyst; 7 patients died after liver tumor ablation with ethanol injection (6 after one-shot treatments and 1 after multisession treatments). Major complications after liver tumor ablative procedures included 10 cases of acute liver failure, 2 cases of acute tubular necrosis, 2 cases of self-limiting hemoperitoneum, 2 cases of paralytic ileum, 2 abscesses, and 1 case of cholangitis. One case of a biliary cyst fistula and 1 case of intracystic hemorrhage occurred after treatment of hydatid liver cysts. CONCLUSIONS: Sonographically guided diagnostic biopsy of focal liver lesions and liver abscess drainage are safe procedures. In contrast, liver tumor ablation procedures have a low but definite risk of mortality and major complications. Puncture of hydatid cysts must be performed only in institutions that can treat anaphylactic shock.     

B超引导下穿刺注射无水乙醇治疗肾囊肿

目的 探讨B超引导下经皮穿刺注射无水乙醇治疗肾囊肿的疗效。方法 1991～2002年在B超引导下穿刺注射无水乙醇进行硬化治疗肾囊肿76例。结果 76例囊肿均一次穿刺成功，术后随访3个月～2年，76例肾囊肿全部闭合，治愈率100％。一次硬化治疗成功率98．6％。结论 在B超引导下经皮穿刺注射无水乙醇硬化治疗肾囊肿简单易行，并发症少，疗效确切，可作为肾囊肿的首选治疗方法。     

超声引导穿刺注入不同药物治疗卵巢子宫内膜异位囊肿的疗效比较

目的：超声引导经腹穿刺卵巢子宫内膜异位囊肿注入不同药物观察,不同治疗方法的疗效。方法：76例患者共86个囊肿,其中子宫内膜异位囊肿52个,卵巢单房囊肿34个;直径4~5cm的囊肿36个,5cm以上的囊肿50个。分别用无水乙醇（A1组、A2组）,消痔灵（B1组、B2组）注入囊肿治疗。囊内液体较稠厚者为A1组,囊内液体较清者为B1组,术后半年评价疗效。结果：A1组总有效率为84.38%（27/32）;B1组总有效率为85%（17/20）。卵巢单房囊肿组总有效率A2组与B2组均为100%。不良反应发生率为A1组为81.25%（26/32）;B1组：45.00%（9/20）结论：超声引导下经皮穿刺注射无水乙醇或消痔灵均为卵巢子宫内膜异位囊肿的有效治疗方法。与无水乙醇比较,消痔灵的不良反应发生率明显较低,应根据不同的患者情况科学选用这两种方法,相互结合能使卵巢子宫内膜异位囊肿的治疗达到最优化,疗效最大化。