超声引导下经皮肾囊肿穿刺注射无水酒精疗效的评价

目的：观察超声引导下肾穿刺注射无水酒精治疗肾囊肿１１８列的疗效。方法：在Ｂ超引导下经皮穿刺肾囊肿抽液后向肾囊肿内注射无水酒精。结果：１１８例共１７３个肾囊肿经无水酒精治疗后复查发现总治愈率为８７．２８％,总显效率为９６．５３％,总有效率为９９．４２％。结论：该方法具有疗效好、穿刺准确、方法简便、经济、安全等优点。     

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。     

腹腔镜下肝肾囊肿开窗去顶术的临床应用

目的:探讨腹腔镜治疗肝肾囊肿的方法和效果。方法: 1994至2004年于腹腔镜下为68例肝肾囊肿患者行开窗去顶术,其中肝囊肿56例,肾囊肿12例,并注入无水酒精灌洗残留粘膜。结果: 68例手术全部成功,无中转开腹。手术时间30~70min,随访时间6个月~10年, 1例复发。结论:腹腔镜治疗肝肾囊肿安全可行,在严格掌握适应证的条件下值得推广应用。     

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.     

经皮穿刺肾囊肿内注射复方铝溶液远期疗效观察

目的：提高穿刺肾囊肿的治疗效果。方法：回顾性分析1295例肾囊肿患者行B超引导下经皮穿刺肾囊肿内注射复方铝溶液治疗的远期疗效。其中单纯性肾囊肿1142例，多发性肾囊肿153例，共计1529个肾囊肿。结果：1295例随访6个月，治愈率85.4％(1306／1529)，显效率13．0％(199／1529)，总有效率98．4％。随访1年复发率0．75％(6／798)，3年复发率0.92％(5／546)，5年复发率1.72％(3／174)，10年以上复发率为1．41％(1／71)。穿刺术后2周内患者腰部稍有胀痛不适40例(3.10％)，未出现感染、发热、腰部剧痛、头痛及头晕等。结论：B超引导下穿刺肾囊肿，囊内灌注复方铝溶液治疗肾囊肿远期疗效好，患者易于接受。     

超声导向无水酒精注射治疗肝囊肿

作者报告了在B超引导下经皮肝穿刺无水酒精注射治疗肝囊肿21例。囊肿直径平均7.2cm,囊液量平均240ml。无水酒精注射次数1～3次,术后2～6个月囊肿完全消失18例。远期随访平均36个月,治愈18例,另3例仍在治疗观察中。对肝囊肿合并胆瘘或感染的3例病人,作者采用穿刺置管法,待胆瘘闭合,感染控制后再注入无水酒精,效果亦满意。     

超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓

目的探讨超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓的技术可行性及其疗效。方法报道2005年2月至2007年9月收治的37例原发性肝癌切除术后单发性门静脉分支癌栓行超声引导经皮肝穿注射无水酒精联合微波固化37例的疗效。无水酒精治疗每周1次，连续4周，第5周微波固化1次。随访时间12个月。结果治疗后6个月5例血清甲胎蛋白转阴，13例低于治疗前水平。7例癌栓缩小，25例出现癌栓生长静止期；无效组5例癌栓范围扩大或合并肿瘤转移。治疗后随访6个月和12个月总存活率分别为86．5％和62．2％。结论超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓的技术可行，有一定疗效，可延长患者生存时间。     

敬告

自1998年起我院对肾囊肿病人进行CT和超声双重定位穿刺治疗51例,58个囊肿,并对治疗方法及注射药物进行改进,取得较好的疗效。     

后腹腔镜下肾囊肿分型治疗的疗效观察

目的探讨后腹腔镜对单纯肾囊肿进行分型、治疗及其疗效观察。方法回顾性分析71例后腹腔镜手术治疗单纯肾囊肿患者的临床资料，初期23例未作分型直接行囊肿去顶，后期48例对囊肿分型后进行个性化治疗。结果初期23例未作分型处理的患者于术后3个月复查，7例（30．4％）有不同程度的残腔存留和复发；后期48例对囊肿分型（Ⅰ型18例、Ⅱ型21例、Ⅲ型9例）并作相应手术处理的患者术后3个月复查，2例有少量残腔存留（4．16％）。结论后腹腔镜手术治疗肾囊肿疗效确切，对肾囊肿分型并在术中进行个性化处理可提高疗效、降低术后复发率。     

99．5％酒精注射治疗肾囊肿的疗效观察

青海省海南州人民医院从1989～2004年对13例单纯性肾囊肿进行经皮穿刺注射99．5％的酒精治疗，疗效满意现报告如下。     

多途径介入治疗肝癌的疗效分析

目的 探讨多途径介入治疗肝癌，并对其疗效加以分析。方法 34个肝癌病灶（26例）的多作乱介入性治疗在超声引导下进行。＜3cm20个病灶,局部微波治疗＋门静脉化疗；＞3cm14个病灶，12个病灶行局部无水酒精注射治疗＋门静脉化疗，2个病灶行局部微波治疗＋无水酒精注射治疗＋门静脉化疗；7例合并门静脉癌栓者，加做门静脉癌栓内无水酒精注射治疗。结果 随访12－25个月，一年生存率100％，两年生存率88.42%。微波治疗组均经活栓证实完全性坏死；无水酒精注射治疗组US及CT报告病灶稳定。门静脉化疗预防组无癌栓出现；治疗组癌栓4例缩小，3例消失。结论 多途径介入治疗对预防肝癌转移，延迟复发，改善预后有肯定意义，明显延和生存期。     

彩超引导介入治疗腘窝囊肿23例

目的探讨彩超引导下腘窝囊肿介入治疗的价值。方法在彩超引导下穿刺囊肿并抽尽囊液，生理盐水反复冲洗囊腔后注入无水乙醇，5min后抽出，反复2～3次。结果23例中22例穿刺一次治愈，1例穿刺2次治愈。23例随访6个月，无复发。结论彩超引导下介入治疗腘窝囊肿操作简便，创伤轻微，安全可靠，效果显著，可重复操作。     

Renal cysts: can percutaneous ethanol injections be considered an alternative to surgery?

AIM: To evaluate the efficacy of a new sclerotization technique with pure ethanol in the treatment of symptomatic renal cysts. PATIENTS AND METHODS: Fourteen patients having renal cysts with a meant diameter of 10 (range 5-15) cm were treated. Our technique includes: ultrasound-guided percutaneous puncture with an 18-gauge needle, positioning of a 5-Fr catheter, complete cyst fluid aspiration, injection of pure alcohol equal to 15% of the initial cyst volume, and alcohol aspiration after 90 min. The procedure was repeated eight times within 5 days. The patients were followed up by ultrasound and/or CT scan for 1 year. RESULTS: All patients became symptom free. Follow-up showed a progressive reduction of the cyst diameter in all cases. Three cysts only (in 2 patients; cyst diameter <2 cm) persisted after 12 months. No significant complications were observed. CONCLUSIONS: In our experience, injections of pure ethanol in renal cysts, repeated after some days, were effective in eliminating recurrences and related symptoms. The procedure was not associated with significant complications. Our findings suggest that it be considered the first-choice procedure in the treatment of renal cysts, due to the good results and the low cost of ethanol.     

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。     

彩色多普勒超声引导下经皮穿刺留置中心静脉导管引流并反复无水乙醇硬化法治疗单纯性肾囊肿

目的 探讨彩色多普勒超声引导下经皮穿刺留置中心静脉导管引流并反复无水乙醇硬化法治疗单纯性肾囊肿的治疗方法 和临床应用价值.方法 对58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留置中心静脉导管引流并反复无水乙醇硬化法治疗.结果所有患者均一次性穿刺成功,成功率100%,术后均放置中心静脉导管.经引流管共注射无水乙...     

超声引导介入治疗1116例肾囊肿的疗效观察

目的观察总结95%无水乙醇、四环素和消痔灵注射液(以下简称消痔灵)等介入性治疗方法对肾囊肿的疗效。方法2001年1月-2005年5月将1116例肾囊肿分为3个治疗组:95%无水乙醇组402例;四环素组362例;消痔灵352例。结果95%无水乙醇组:治愈394例,显效8例,有效0例,无效0例,总有效率100%。四环素组:治愈269例,显效32例,有效35例,无效26例,总有效率92.8%。消痔灵组:治愈320例,显效15例,有效13例,无效4例,总有效率98.8%。结论95%无水乙醇、四环素、消痔灵等超声引导下介入性治疗肾囊肿安全有效,治愈率高,可取代开腹手术治疗。其中95%无水乙醇疗效明显优于消痔灵及四环素,消痔灵优于四环素。     

无水乙醇肾动脉栓塞治疗肾癌

目的 减少肾癌术中出血以及提高姑治疗晚期肾癌疗效。方法 采用Ｓｅｌｄｉｎｇｅｒ技术用无水乙醇行２５例吕肾动脉栓塞术。其中行根治性肾切除术２０例,肾切除４例。结果 栓塞术后行肾癌根治术２０例,单纯肾切除术４例,１例未手术。平均出血量２１０ｍｌ,无死亡及严重并发症,但均有不同程度腰痛及发热。结论 无水乙醇行肾动脉栓塞,方法简单,效果显著,副作用轻,是可行的辅助治疗方法。     

Percutaneous treatment of large symptomatic renal cysts

PURPOSE: To evaluate the efficacy of alcohol in combination with tetracycline for the treatment of symptomatic renal cysts. PATIENTS AND METHODS: Twenty-four patients age 45 to 77 years (mean 66 years) with a large (5-13-cm; mean 7.5-cm) symptomatic renal cyst associated with flank pain were treated by aspiration under ultrasound guidance and injection of alcohol and tetracycline. Patients were followed with ultrasonography at 1, 6, and 12 months and once a year thereafter. RESULTS: The aspirated volume ranged from 65 to 1500 mL (mean 360.5 mL). Two patients experienced mild pain during alcohol injection, but the procedure was completed successfully. One patient reported severe pain after tetracycline injection. The tetracycline was immediately aspirated, and the procedure was then aborted. The remaining patients were relieved of their symptoms after treatment, and they remained symptom free during a mean follow-up of 20 months (range 7-36 months). CONCLUSIONS: The combination of alcohol and tetracycline is safe and effective and offers a very favorable minimally invasive therapeutic alternative for the treatment of symptomatic renal cysts.     

Percutaneous renal cyst puncture and ethanol instillation]

Under ultrasound guidance 79 simple renal cysts in 65 patients were punctured and aspirated with our contrivance, a 5 Fr single J catheter on a 19 gauge needle. Forty-eight renal cysts were successfully punctured, that is, they had no bloody fluid and did not have any leakage of contrast medium. These cysts were instilled with absolute ethanol for 5 minutes. To follow up the patients, consecutive observation was done by sonography or CT every three months. Ethanol-instilled renal cysts were more markedly reduced (reduction rate: 93 +/- 17%) than not-instilled cysts (reduction rate: 32 +/- 28%). Thus, ethanol-instillation was useful in the reduction of renal cysts. After the puncture of cysts, hematuria disappeared in most patients.     

B超引导结合穿刺注药治疗肾囊肿

本文报告采用B超引导经皮穿刺注药治疗肾囊肿25例,取得满意疗效。并就肾囊肿的诊断方法及治疗进行讨论。