CT引导下穿刺硬化治疗肾盂旁囊肿

目的 探讨CT引导下经皮穿刺抽吸硬化治疗肾盂旁囊肿的临床应用价值.方法 回顾分析在CT 引导下经皮穿刺抽吸硬化治疗肾盂旁囊肿患者7例.治疗要点包括选择最佳层面、穿刺点、进针角度及深度;抽净囊液,注入无水乙醇并保留.结果 7例均穿刺成功,治愈率100％,无严重并发症发生.结论 CT引导下经皮穿刺抽吸注硬化剂治疗肾盂旁囊肿,穿刺成功率高,并发症少,疗效显著,是治疗肾盂旁囊肿的首选方法,值得临床推广应用.     

Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol

BACKGROUND: Esophageal variceal sclerotherapy (EVS) is an effective means of controlling variceal hemorrhage. However, it causes a wide variety of local and systemic complications. The present study was performed to document pleuropulmonary complications of EVS with absolute alcohol. METHODS: Twenty-six patients of portal hypertension of different etiologies were subjected to EVS with absolute alcohol. Baseline arterial blood gas analysis (PaO2, PaCO2, pH, HCO3, SaO2), chest X-ray and pulmonary function tests (forced expiratory volume at 1 s (FEV1), forced expiratory vital capacity (FVC), FEV1/FVC, maximum mid-expiratory flow rate (MMFR), and peak expiratory flow rate (PEFR)) were performed 4-6 h before the first session of EVS. These investigations were repeated within 24 h of EVS. Patients were asked to maintain a symptom diary and to record symptoms such as fever, chest pain, dysphagia and dyspnea during the study period. RESULTS: Ten patients (38.46%) had chest pain and four patients (15.68%) had fever after sclerotherapy. Eight patients (30.54%) complained of dyspnea and six patients (23.08%) developed pleural effusion. There was a significant decline in FVC and FEV1 after EVS as compared with baseline values. However, FEV1/FVC ratio, MMFR and PEFR did not have any significant change. CONCLUSIONS: Chest pain (38.46%), dyspnea (30.54%) and fever (15.68%) were the common symptoms after EVS while chest X-ray showed pleural effusion in 23.08%. Pulmonary function tests revealed a significant decline in FEV1 and FVC without change in FEV1/FVC ratio after EVS, suggesting a restrictive type of defect.