CT引导下肾囊肿穿刺硬化剂治疗的评价

目的 :分析影响CT导引下穿刺硬化剂治疗肾囊肿疗效的因素和预防并发症的方法。方法 :对 96例 13 5个肾囊肿行CT导引下无水乙醇 (纯度 99.7% )硬化治疗 ,囊肿直径 2 .8～ 12 .0cm ,用 2 0G抽吸针穿刺 ,抽液后注入无水乙醇 ,注入量为抽出液的 2 5 .0 %。留置 15min后抽出注入的无水乙醇 ,重新注入少量无水乙醇保留。对于囊液大于 3 0 0ml的囊肿则多次冲洗 ,直至抽出液清亮。结果 :该组随访 5 1例 ,有效率 94.1% ,囊肿消失率 84.3 % ,无严重并发症发生。结论 :CT导引下穿刺硬化剂治疗肾囊肿方法简便 ,疗效好 ,并发症少 ,是一种非常有价值的治疗方法。     

CT引导下介入治疗肾囊肿的临床应用

目的探讨CT引导下穿刺硬化剂治疗肾囊肿的方法及疗效。方法经B超或CT诊断的78例84个肾囊肿在CT定位下经皮穿刺抽吸,行无水乙醇反复冲洗法硬化剂治疗,用18~22 G穿刺针抽吸,注入99.7%无水乙醇,注射量为抽出囊液量的25%~30%。术后每隔3个月复查,随访其疗效。结果其中79个囊肿一次穿刺成功,随访3个月~1年,复查见51例54个囊肿消失,22例24个囊肿缩小,4例4个囊肿未见缩小。有效率95.2%,消失率64.2%,无严重并发症。结论CT引导下经皮穿刺硬化剂治疗肾囊肿是一种安全、有效的治疗方法,具有较高的临床实用价值。     

CT介入肾囊肿反复冲洗法硬化治疗

目的　对比CT导引下肾囊肿单次和反复冲洗法硬化治疗的疗效。方法　选 96例单发肾囊肿采用经皮穿刺硬化治疗。其中 45例 (A组 )采用常规单次法 ,即抽出囊液后立即注入 99.7%无水乙醇 ,保留后再抽出。 5 1例 (B组 )采用反复冲洗法 ,反复冲洗至少 1～ 2次 ,保留后再抽出。结果　本组全部经B超或CT随访 ,随访时间为 3～ 6个月 ,A组治疗有效率为 91.1% ,治愈率为62 .2 %。B组治疗有效率为 98.8% ,治愈率为 80 .4%。A、B 2组治愈率对比有差异 (Ρ <0 .0 5 )。结论　CT导引下经皮穿刺抽吸硬化剂治疗肾囊肿具有疗效高、并发症低、创伤小的特点 ,采用反复冲洗法能提高治愈率、降低复发率。     

超声引导下经皮穿刺抽吸和注射无水乙醇治疗单纯性肾囊肿

目的评价超声引导下经皮穿刺抽吸和注射无水乙醇治疗单纯性肾囊肿的效果。方法46例单纯性肾囊肿患者(男性26例,女性20例,平均年龄65岁)均经超声引导经皮穿刺抽吸和注射无水乙醇硬化治疗。全部操作是在局部麻醉下完成的。治疗后,全部病人经超声或CT随访1至6个月。囊肿与治疗前比较,减小2/3以上为有效,完全消失为治愈。结果46个囊肿中,2个囊肿抽出液蛋白定性试验阴性,抽液后未注入无水乙醇,其余44个囊肿于治后1,3,6个月呈进行性缩小,6个月时复查有效率为100%,治愈率为90.6%。结论超声引导经皮穿刺抽吸和注射无水乙醇是治疗单纯性肾囊肿的一种操作简单、痛苦小、费用低、安全有效的方法,值得临床推广应用。     

CT导引下穿刺注射无水乙醇治疗肾囊肿

目的　评估CT导引经皮穿刺肾囊肿注射无水乙醇治疗的临床经验。方法　 4 4 5例 5 10个肾囊肿于CT导引下经皮穿刺肾囊肿抽液后注射无水乙醇治疗 ,4 4 5例中 385例为单发肾囊肿 ,5 3例多发肾囊肿 ,7例多囊肾。囊肿直径为 1.9～ 13.5cm。用 18～ 2 1G抽吸针穿刺抽吸 ,抽出囊液量为 3～780ml。注入 99.7%乙醇 ,乙醇量以抽出囊液的 2 5 %为合适。结果　本组 396例 (42 7个囊肿 )用CT扫描或超声检查随访 ,随访时间为 3个月到 1年以上 ,单发肾囊肿疗效为 97% ,其中囊腔消失为 82 % ,多发肾囊肿疗效为 95 % ,其中囊腔消失为 79% ,多囊肾疗效为 6 7%。并发症为局部疼痛 (2 8例 ) ,血尿 (4例 ) ,无严重并发症出现。结论　CT导引经皮穿刺肾囊肿乙醇治疗对单发肾囊肿和多发囊肿是一种有价值的治疗方法     

CT引导下肾囊肿、卵巢囊肿穿刺硬化治疗的临床应用

目的探讨CT引导下肾囊肿、卵巢囊肿穿刺硬化治疗的临床应用价值。方法在CT引导下经皮穿刺肾囊肿、卵巢囊肿,根据预定方案针尖位于最佳位置后,开始抽吸囊液,抽尽囊液后,按抽出量的25%注入无水乙醇3~5 m in后再抽取囊液,重复此操作3~4次,据囊肿大小注入3~15 m l无水乙醇保留于囊腔,拔针,CT扫描穿刺部位观察有无特殊改变,术后嘱患者辗转体位3~5次使无水乙醇充分接触囊壁。结果32例患者手术后,30例完全消失,2例缩小达85%,有效率100%。结论CT引导下肾囊肿、卵巢囊肿穿刺硬化剂治疗方法简便、创伤小、痛苦小、恢复快、费用低、疗效高、并发症少,是一种非常有价值的治疗方法。     

CT导引下肝肾囊肿抽吸硬化治疗

目的：总结CT导引下肝肾囊肿穿刺抽吸硬化治疗的疗效和操作经验。材料和方法：肝囊肿11，肾囊肿15例，多囊肾1例，囊肿大小为3．5－12cm，均用15cm长20GGreene针穿刺治疗，抽出囊液量为21－550ml，囊液抽净后注入99．7％的无水酒精。结果：治疗后症状均有明显好转或消失，本组随访肝囊肿7例、肾囊肿11例，疗效指数I级1例（多囊肾），Ⅱ级肝肾囊肿各2例，Ⅲ级肝囊肿5例肾囊肿8例。穿刺操作顺利，无严重并发症发生。结论：CT导引下肝肾囊肿抽吸硬化治疗操作简便、创伤小、疗效高可作为替代外科手术的有效的治疗方法，多囊肾的单纯抽吸治疗可明显减轻症状，改善肾功能，是一种较好的治疗手段。     

CT导引下卵巢巧克力囊肿穿刺硬化剂治疗的临床应用

目的 探讨CT导引下卵巢巧克力囊肿穿刺硬化剂治疗的临床应用价值.方法 在CT导引下,经皮穿刺囊肿,针尖位置满意后开始抽吸囊液,囊液抽尽注入抽出量25.0%的无水乙醇,保留10～15 min后抽出,然后注入5～10 ml无水乙醇保留.结果 16例中总有效率100%,其中14例囊腔完全消失,2例囊腔缩小达85%～90%.结论 CT导引下卵巢巧克力囊肿治疗方法 简便,疗效可靠,值得临床应用推广.     

CT导引下聚桂醇硬化治疗肾囊肿

目的 评价CT导引下聚桂醇硬化治疗肾囊肿的临床效果。方法 回顾性分析2019年1月至2021年12月在上海市第六人民医院东院接受CT导引下肾囊肿穿刺硬化治疗的50例（52枚）肾囊肿患者临床资料。术前完善出凝血功能、肝肾功能及增强CT检查，排除禁忌病例，确定治疗体位和聚桂醇用量。术中使用Bard 18 G活检针穿刺抽液，囊液吸净后用0.9%氯化钠溶液40～100 mL冲洗1～2次，注入聚桂醇泡沫硬化剂（氧气和聚桂醇按1∶1配比）。参照WHO实体瘤疗效评价标准评价硬化治疗效果。结果 所有患者肾囊肿穿刺一次成功。囊肿大小范围为4.3～12 cm，抽出囊液40～900 mL，颜色淡黄或清亮。囊肿内注入聚桂醇泡沫剂15～60 mL。抽吸硬化治疗全程顺利，患者均无并发症发生。术后所有患者临床症状明显好转或消失。术后3、6个月随访显示，总显效率、有效率分别为71.15%、98.07%。结论 CT导引下聚桂醇硬化治疗肾囊肿创伤小、操作简单、费用低、住院时间短、效果显著，可替代外科手术治疗。尤其是对肾上极囊肿硬化治疗，CT导引优于超声导引。     

肾囊肿的穿刺硬化剂治疗（附235例报告）

目的：总结ＣＴ导引下穿刺硬化剂治疗肾囊肿的经验。材料与方法：２３５例２７０个肾囊肿经皮穿刺抽吸酒精治疗，其中１８６例为单纯肾囊肿，４４例多发囊肿，５例多囊肾。囊肿大小直径为１．９～１３．５ｃｍ。用１９～２１Ｇ抽吸针穿刺抽吸，抽出囊液为３～７８０ｍｌ。注入９９．７％无水酒精，酒精量以抽出囊液的２５．０％为合适。结果：本组随访病例９７例（１０６个肾囊肿），随访时间为３个月以内到１年以上，单纯囊肿疗效为９７．１％，其中囊腔消失为７２．１％；多发囊肿和多囊肾的疗效为７６．３％，其中囊肿消失为３６．８％。并发症为局部疼痛（６．４％），无严重的并发症。结论：ＣＴ导引下经皮穿刺抽吸硬化剂治疗肾囊肿是一种安全、并发症低、疗效高的有价值的治疗方法。     

CT导引下肾囊肿穿刺硬化剂治疗

This report presented fifty-eight renal cysts in 50 patients treated with percutaneous aspiration and alcohol injection. The cysts varied in size from 2.3 cm to approximately 13.5 cm in diameter, the amount of aspirated fluid varied from 5 ml to 780 ml. Forty-three of 58 renal cysts were followed from 3 months to one year. The curative effective rate was 95.3% and in 65.1%, the cystic cavity disappeared. The method technique, indication and preliminary experience were discussed.     

肝肾囊肿硬化剂疗效评价及彩色多普勒超声导向作用

目的观察超声引导下肝肾穿刺注射无水酒精治疗肝肾囊肿158例的疗效和彩色多普勒超声导向作用。方法在彩色多普勒超声引导下,经皮穿刺肝肾囊肿抽液后向肝肾囊肿内注射无水酒精。结果158例共173个肝肾囊肿经无水酒精治疗后复查总治愈率为81．5％、总显效率为97．7％。其中7例患者在治疗后出现不同程度的头晕、恶心等,15例患者注入无水酒精后或拔出针后出现肝区、腰部胀痛或不同程度腹痛,休息后均可缓解,无出血、感染、剧痛等严重并发征。结论彩色多普勒超声导向能成功避开肝肾大血管防止术中出血,并能进行囊肿的鉴别诊断。该方法具有疗效好、穿刺准确、方法简便、经济、安全等优点。     

Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy

We treated 35 patients who had hepatic cysts (30 congenital cysts, 5 hydatid cysts) with percutaneous puncture and sclerotherapy. After puncture and drainage of the cyst, a 95% alcohol solution was instilled as sclerosing agent into the cystic cavity. In all the patients, cyst puncture and drainage was successful. Follow-up in all cases was at least 12 months. In three uncooperative patients, cysts recurred due to incomplete sclerosis of the lining epithelium of the cyst wall. No major complications were encountered in all cases. All congenital cysts were treated on an outpatient basis. Patients with hydatid cyst were hospitalized for 48 h after puncture and aspiration. In our opinion, percutaneous drainage and sclerosis of congenital hepatic cysts can be considered an effective alternative to surgical treatment.     

Abdominal hydatid disease: long-term results of percutaneous treatment

Purpose: To evaluate the effectiveness of percutaneous treatment under sonographic guidance in abdominal hydatid cysts.

Material and Methods: Fifty-two hydatid cysts in 33 patients were treated using a percutaneous approach under sonographic guidance. Forty-five cysts were located in the liver, 6 in the spleen, and 1 in the pancreas. Forty-nine cysts were type I, and 3 were type II. Thirty-one cysts in 15 patients were treated with puncture and aspiration of the contents, injection of hypertonic saline solution, and respiration (PAIR); 15 cysts in 14 patients were treated with puncture, aspiration of cyst contents, injection of hypertonic saline solution, drainage, and injection of sclerosing agent (PAIDS); and 6 cysts in 4 patients were treated with puncture, aspiration of cyst contents, injection of sclerosing agent, and re-aspiration (mPAIDS). Hypertonic saline or alcohol was used as a scolicidal agent. The follow-up period was between 17 and 53 months.

Results: A decrease in the dimensions of the cysts, solidification of the contents, and irregularity in the walls of cysts, all of which were considered signs of cure, were found in all patients. Recurrence was observed in one case and anaphylaxis in one.

Conclusion: Percutaneous treatment of abdominal hydatid cysts is a safe, easily applicable, well-tolerated, and effective method.     

一次CT导引下置双针穿刺硬化治疗双肾多发肾囊肿的应用体会

目的 探讨一次CT导引下于左右两侧肾区分别置针进行穿刺抽吸、注射硬化剂治疗肾囊肿的应用价值.方法 在一次CT导引下分别于脊柱两侧肾区内确定穿刺点、设计穿刺路径,分别给予交替穿刺、抽吸、冲洗、保留乙醇等治疗步骤,对19例多发肾囊肿进行硬化治疗.结果 通过对19例两侧多发肾囊肿患者同时进行硬化治疗的时间统计,最短延长20 ...     

One-year Results of Single-session Sclerotherapy with Bleomycin in Simple Renal Cysts

PurposeTo evaluate the efficacy and safety of single-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy for the treatment of simple renal cysts.Materials and MethodsA total of 66 renal cysts in 53 patients were treated by single-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy under computed tomography (CT) guidance. Symptomatic (n = 31) and asymptomatic cysts (n = 22) with maximum diameters greater than 5 cm were treated. As much liquid content of each cyst was aspirated as possible, and bleomycin was injected and remained in the cyst. Follow-up was performed with ultrasonography or CT every 3 months until 1 year, and cyst volume was calculated before and after sclerotherapy. Therapeutic response was assessed by cyst volume reduction rate (VRR) and classified as complete regression (CR; ie, invisible), near-CR (ie, VRR>85%), partial regression (PR; ie, VRR of 50%–85%), or no response (NR; ie, VRR<50%). Medical records were reviewed to analyze complications.ResultsCysts refilled partially in the initial stage after sclerotherapy and decreased gradually in size over the entire follow-up period. At 1-year follow-up, the overall response rate was 98.5% (65 of 66), with CR in 31 cysts (47.0%), near-CR in 24 cysts (36.4%), PR in 10 cysts (15.1%), and NR in one cyst (1.5%). No major complications were encountered.ConclusionsSingle-session percutaneous needle aspiration and single-injection bleomycin sclerotherapy is a simple, safe, effective, well tolerated alternative technique for management of simple renal cysts.     

Hepatic cysts: treatment with alcohol

Six patients with hepatic cysts were successfully treated with percutaneous aspiration and temporary direct injection of sterile alcohol U.S.P. (95% ethanol) into the cyst cavities through an aspiration catheter. Five cysts were treated percutaneously using sonographic guidance, and one cyst was treated under direct vision during a cholecystectomy. It is ideal to treat with 25% replacement volume of alcohol. The larger cysts may require more than one alcohol treatment at the same sitting to be effective. There was no recurrence of the treated cysts on follow-up examinations of 6-18 months. Minor complications of transient pain, temperature elevation, and hemorrhage into a cyst occurred. No major complications were encountered. The results of this series would indicate that aspiration and injection of alcohol is the treatment of choice for symptomatic congenital hepatic cysts.