CT导引下肝肾囊肿硬化剂治疗的临床应用分析

目的评价肝、肾囊肿CT导引下经皮硬化剂治疗的疗效。方法先行CT扫描定位。41例41个囊肿用24G、21G穿刺抽吸针抽吸或引流管，一次或多次抽吸囊液并注入硬化剂无水酒精到囊腔内。囊肿直径为4～19cm，抽出囊液30～2700mL。其中肝囊肿30例30个囊肿，5例5个肝大囊肿分3次抽吸；肾囊肿11例11个囊肿。结果有5例大肝囊肿3次抽吸，但是2例不能完全抽尽，复查CT见囊肿仍较大，行外科手术治疗。其中1例肝大囊肿穿刺术中囊肿破裂，有囊液溢出，造成腹膜炎，急行普外手术。随访38例囊肿3个月～2年，疗效明显，其中37例中、小囊肿消失或仅留不规则小囊腔，其中1例术前18cm×14cm×11cm的大囊肿囊腔仍有6cm×8cm×5cm大小。结论CT导引下经皮硬化剂治疗肝、肾囊肿是一种危险性小、并发症少而疗效好的方法，但大囊肿疗效差。

Clinical application analysis of absolute alcohol treatment for hepatic and renal cyst under the guidance of CT

Objective To evaluate the efficacy of percutaneous absolute alcohol treatment for hepatic and renal cyst under the guidance of CT. Methods The CT scanning was done at first. 41 cysts in 41 cases were used 24G, 21G punctures and aspiration needles to suction or drainage tubes, the cyst fluid was suctioned one or many and absolute alcohol was injected into lumen. The diameter of cyst was 4-19 cm. The suctioned cyst fluid was 30-2700 mL. Of all there were 30 cysts in 30 cases with hepatic cyst, 5 large hepatic cysts of 5 cases were suctioned three times; and 11 cysts in 11 cases with renal cyst. Results There were 5 cases of large hepatic cysts with three times aspiration, but 2 cases were unable to fully exhaust, the CT review showed that the cysts were still larger and were given surgical treatment. Of all 1 case with large hepatic cysts ruptured in the puncture, the overflow of cyst fluid leaded to peritonitis that was given emergency general surgery. 38 cases of cyst were followed up during three months to 2 years, the curative effects were obvious, of which 37 cases occurred the disappearance of middle and small cysts or remained only small irregular lumen, the lumen size of 1 case with large cyst was 6cm×8cm×5cm,while preoperative lumen size was 18cm×14cm×11cm. Conclusion Percutaneous absolute alcohol treatment for hepatic and renal cyst under the guidance of CT is the method with small risk, less complications and good curative effect, but the curative effect is poor for large cysts.