超声引导下肝肾包膜下囊肿穿刺抽液最佳路径

目的对比分析超声介导下两种穿刺路径对于肝肾包膜下囊肿的抽液疗效。方法将129例肝肾包膜下囊肿患者,随机分为改良组及传统组,于超声引导下行囊肿穿刺抽吸术。改良组将穿刺路径定于囊腔偏心侧靠近肝肾实质处,传统组将穿刺路径定于囊腔中心处,比较两组的囊液抽吸率及安全性。结果改良组63例,抽吸完全56例(56/63,88.89%),7例有残液,残液量13~34ml,抽吸率为78.3%~100%。传统组66例,抽吸完全51例(51/66,77.27%),15例有残液,残液量18~57ml,抽吸率为60.8%~100%。改良组囊液抽吸完全例数及抽吸率均高于传统组,差异均有统计学意义(P均0.05)。两组操作过程中均未出现明显并发症。传统组中3例行抽液时针尖脱落在外,无法进行硬化治疗。结论改良的穿刺路径更适用于肝肾包膜下囊肿,对于抽吸更多的囊液及进一步硬化治疗具有重要的意义。

Optimal path of ultrasound-guided percutaneous needle aspiration of infracapsule hepatic and renal cysts

Objective To compare the curative effect of ultrasound-guided needle aspiration of infracapsule hepatic and renal cysts between the modified method and the traditional method. Methods A total of 129 patients who had infracapsule hepatic or renal cysts were randomly assigned to two groups. One group (group A) was treated with the modified method by placing the puncture needle close to the hepatic or renal parenchyma. Whereas the other group (group B) was treated with the traditional method by placing the puncture needle in the middle of the cysts. The operational aspiration ratio and complications were compared between the two groups. Results In group A including 63 patients, the completely aspiration cases were 56 (56/63, 88.89%), and 7 cases with remnant liquid range from 13-34 ml, the aspiration ratio were 78.3%-100%. In group B including 66 cases, the completely aspiration cases were 51 (51/66, 77.27%), 15 cases with remnant liquid range from 18-57 ml, the aspiration ratio were 60.8%-100%. The completely aspiration cases and aspiration ratio of group A were higher than those of group B (both P<0.05). No major complications happened in either group except three cases of group B with the puncture needle dropped out of the cysts during the operational procedure so the sclerotherapy could not carry on. Conclusion Compared with the traditional method, the modified approach resulted in a higher adequate aspiration rate in the treatment of infracapsule hepatic and renal cysts. It could be a good option for patients who need sclerotherapy.