多囊肾经皮穿刺注射复方铝溶液的疗效观察

我们采用B超引导下经皮穿刺多囊肾，囊内注射复方铝溶液（3％硫酸铝钾溶液）治疗多囊肾143例，对其安全性、有效性及远期疗效进行了随访观察，现报告如下。     

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。     

四种不同方法治疗肾囊肿的临床价值

目的探讨不同方法治疗肾囊肿的临床价值。方法回顾性分析2001年4月~2004年3月158例肾囊肿患者的临床资料,其中B超引导下经皮肾穿刺注射无水乙醇硬化治疗48例、后腹腔镜手术治疗86例、小切口手术治疗11例及传统的经腰部切口治疗13例。平均随访时间12个月(3~24个月)。随访时间为治疗后1、3、6、12、24个月,B超复查囊肿大小。结果后腹腔镜组创伤小、恢复快、疗效可靠。小切口组创伤较小、医疗费用较低,但手术野暴露较差。传统经腰切口组创伤大,恢复慢但疗效可靠。B超穿刺组安全简便,但远期复发率较高。结论不同方法治疗肾囊肿各有优缺点,腹腔镜手术应列为首选。     

多次灌注持续引流肾囊肿穿刺术探究

目的：研究B超引导下无水乙醇多次灌注持续引流穿刺法治疗单纯性肾囊肿的优点。方法：通过对后腹腔镜下肾囊肿去顶术和B超引导下无水乙醇多次灌注持续引流穿刺法治疗单纯肾囊肿住院时间、治疗费用及疗效的对比。结果：B超引导下无水乙醇多次灌持续引流穿刺法拈花惹草疗效与腹腔镜组差异无统计学意义（P〉0．05），而住院时间及治疗费用差异有统计学意义（P〈0．05）。结论：B超引导下无水乙醇多次灌注持续引流穿刺法，疗效可靠，操作简便，费用低廉，适合基层医院开展。     

超声引导下细针穿刺硬化治疗肾囊肿疗效观察(附216例报告)

探讨超声引导下细针穿刺硬化治疗肾囊肿的疗。效。方法：１９９１－１９９８年在Ｂ超引导下分别采用无水乙醇、四环素针剂、酸化维生素Ｃ行细针穿刺硬化治疗肾囊肿化２１６例。结果：术后３个月随访,无水乙醇有效率为９５．７４％,四环素针剂有效率为８９．７４％,酸化维生素Ｃ有效为９３．９８％,三者经Ｘ＾２检验无显著性差异。     

经皮穿刺注入四环素后持续引流治疗单纯性肾囊肿(46例分析)

目的探讨单纯性肾囊肿穿刺注入四环素后持续引流的治疗效果。方法对46例单纯性肾囊肿患者在B超引导下行囊肿穿刺抽出囊液后注入四环素,留置导管,持续引流1周。结果拔管后,囊肿闭合消失率为100%,41例患者获得随防,随访1～4年,未复发者38例(92.6%)。结论采取穿刺注入四环素后持续引流治疗单纯性肾囊肿是一种有效手段。     

B超引导下注射无水乙醇治疗肾囊肿80例

目的探讨B超引导下注射无水乙醇治疗肾囊肿的临床效果。方法自1995年12月-2004年12月应用B超引导下注射无水乙醇治疗肾囊肿80例，其中右侧44例，左侧36例，囊肿位于肾上极33例，下极32例，中极15例。结果80例肾囊肿穿刺82次，76次囊肿消失，3例明显缩小，1例因囊肿大，行多次穿刺。80例中治疗前有肾功能损害者76例，经注射无水乙醇后74例肾功能有所好转，显效率97％。结论B超引导下注射无水乙醇治疗肾囊肿方法简洁、高效、损伤小，尤其适宜基层医院开展。     

B超引导经皮穿刺酒精硬化治疗单纯性肾囊肿120例

目的观察应用B超引导穿刺酒精硬化治疗单纯性肾囊肿的效果。方法对120例单纯性肾囊肿患者予以B超引导穿刺酒精硬化治疗。结果所有病例均一次穿刺成功。术后6个月治愈率约93.3%。结论应用B超引导穿刺酒精硬化治疗单纯性肾囊肿具有创伤小、安全、疗效好、材料易得等优点,是单纯性肾囊肿理想的治疗方法。     

经皮穿刺囊内注射复方铝溶液治疗精液囊肿临床观察

目的 探讨经皮穿刺囊内注射复方铝溶液治疗精液囊肿的临床疗效。方法临床上对40例精液囊肿患者进行囊肿穿刺，囊液抽净后，注入配好的复方铝溶液，无菌敷料加压包扎。治疗后3月评价其治疗效果并追踪观察6月。结果 40例精液囊肿患者中治愈21例（52．5％），有效14例（35％），无效5例（12．5％），有效率达87．5％。其中28例获6月追踪观察，无1例复发。信论经皮穿刺囊内注射复方铝溶液治疗精液囊肿是一种有效的、治愈率较高的治疗方法。     

B超引导经皮穿刺与置管注入无水乙醇治疗肾囊肿的疗效评价

目的 对经皮肾囊肿穿刺与置管注入无水乙醇治疗肾囊肿的疗效评价。方法 64例肾囊肿患者,34例采用直接穿刺注入无水乙醇(A组)、30例采用套管针法注入无水乙醇(B组)行硬化治疗。比较两组囊肿直径大于6cm、小于6cm患者的疗效。结果 全部患者治疗后3～12个月进行CT或B超随访,囊肿直径大于6cm时,两种治疗方法有显著性差异(U=2．712,P=0．007)。结论 套管针法注入无水乙醇行硬化治疗适于直径大于6cm的肾囊肿。     

经皮穿刺囊内注射消痔灵治疗肝囊肿

目的观察经波穿刺囊内注射消痔灵治疗肝囊肿的疗效。方法回顾性分析58例肝囊肿患者,在行B超引导下经皮穿刺肝囊肿内注射消痔灵注射液的临床疗效。结果58例随访10个月,总治愈率94.8%(55/58),显效率5.2%,总有效率100%。未出现感染、发热等。结论B超引导下穿刺囊肿内注射消痔灵治疗肝囊肿是疗效好,方法安全、简便、实用,患者易于接受。     

超声引导肝肾囊肿介入治疗的方法再探

目的对超声引导乙醇治疗肝肾囊肿的方法进行进一步的探讨,使乙醇治疗肝肾囊肿疗效更好,安全性更高。方法采用超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,乙醇总量不予控制为主要方法改进。注重术前认真谈话和彩超引导。结果肝肾囊肿共306个,治愈249个,明显有效48个,有效6个,无效3个。治愈率81.37%,有效率99.02%。其中,肾囊肿189例241个囊肿,有效率100%,治愈率87.55%;肝囊肿59例65个囊肿,有效率95.38%,治愈率58.46%。无一例出现明显的过敏反应、出血等并发症。结论①超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,疗效确切,不良反应少。②肾囊肿的治愈率明显高于肝囊肿(P<0.01);大于10mm的肝囊肿疗效差(P<0.01)。③术前认真谈话和彩超引导也很重要。     

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.     

A new treatment of simple renal cyst: percutaneous instillation of minocycline hydrochloride into simple renal cyst

Minocycline hydrochloride was percutaneously instilled into simple renal cysts to prevent recurrence of renal cysts after the puncture and aspiration of cystic fluid. Fifty-six simple renal cysts in 51 patients were punctured with an 18-gauge needle under ultrasonographic guidance, and the cystic fluid was aspirated under fluoroscopic control. A single 100 mg or 200 mg dose of minocycline hydrochloride dissolved in 5 ml of distilled water was instilled through the needle into the renal cyst. The patients were followed up by computed tomographic (CT) scan and ultrasonography 1, 3, 6 and 12 months after the treatment. Efficacy was evaluated after 3 months or longer. Of 20 renal cysts instilled with 100 mg of minocycline, efficacy was excellent in 10, good in 6 and poor in 4. Of 22 renal cysts instilled with 200 mg of minocycline, efficacy was excellent in 10, good in 9 and poor in 3. No significant difference was noted between the efficacy rate of 100 mg and 200 mg treatments. Complications attributable to treatment were observed in 15 patients: moderate pain in one, slight pain in 6, slight fever in 8 and slight hematuria in one. Neither severe adverse reactions nor infections were observed in any of the patients. These results suggest that the percutaneous instillation of minocycline into simple renal cysts is a new, simple, safe and effective treatment to prevent recurrence of the cyst and additionally to prevent infection following the puncture.     

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。     

肾囊性疾病和肾盏憩室的腔镜下切开内引流术

目的：探讨经皮。肾镜及逆行软性输尿管肾镜下切开内引流术治疗。肾囊性疾病和肾盏憩室的安全性和可行性。方法：回顾性分析2010年1月～2013年2月对23例患者采用经皮肾镜及逆行软性输尿管肾镜下肾囊肿或肾盏憩室内切开引流术的临床资料。其中单纯肾囊肿5例,肾盂旁囊肿11例,肾盏憩室6例,多囊肾1例。囊肿、憩室直径平均4．7cm。手术方法采用全麻,顺行经皮。肾镜或逆行软性输尿管。肾镜下观察囊肿憩室的解剖位置及形态。直视下用钬激光将憩室口内切开扩大或凸起的菲薄囊壁切开一定范围开窗引流,使之与集合系相通。术后留置双J管引流。结果：23例患者均手术成功。手术时间36～75rain,平均48．9min。术后无大出血、严重感染、尿漏等并发症。术后随访3～24个月,11例囊肿消失,5例囊肿明显缩小,6例肾盏憩室消失,1例多囊肾囊肿（直径〉2cm者）数量明显减少。结论：经皮肾镜及逆行软性输尿管肾镜下内切开引流术治疗肾囊性疾病和肾盏憩室具有安全、有效,恢复快的特点,远期疗效有待进一步观察随访。     

B超引导下肾囊肿穿刺要点

目的 探讨彩色多普勒超声引导下肾囊肿穿刺要点.方法 对126例原发性肾囊肿患者进行了彩色多普勒超声引导经皮穿刺治疗.结果 所有患者均一次性穿刺成功,成功率100％,其中肾盂旁囊肿26例,随访0.5～2年,121个囊肿均治愈,治愈率96.03％,均未出现出血与感染等并发症.结论 彩色多普勒超声引导下经皮穿刺治疗肾囊肿,成功率和治愈率高,并发症少.     

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.     

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。     

Percutaneous renal cyst puncture

Ultrasound-guided renal cyst puncture was performed on 31 cysts which were then 95% ethanol instilled to prevent recurrence of cystic fluid. Ethanol was allowed to remain in place for 20 minutes and removed through the catheter. Morphological improvement was observed on IVP and Tc-99m-DMSA renal scintigram, and DMSA renal uptake rate increased slightly. The cystic wall became thicker, and cystic fluid did not remain any more. The renal tissue near the cyst was intact. One third of the patients had hotflush and/or somewhat drunken sense but these symptoms were only temporary. This method of therapy is a safe and effective way of treating renal cysts.