超声引导下穿刺注入50%葡萄糖治疗肝肾单纯性囊肿

目的探讨超声引导下经皮穿刺使用不同方法注入高渗葡萄糖治疗肝肾囊肿的疗效的可靠性。方法回顾性分析于我院接受超声引导下肝肾囊肿高渗葡萄糖（50％葡萄糖）注入治疗的53例患者（54个囊肿）的资料，根据注入高渗葡萄糖的不同方法进行分组，其中I组24例24个囊肿，使用传统的方法注入高渗葡萄糖进行囊肿治疗，即抽出囊液后注入的葡萄糖的量为抽出囊液量的1／3，Ⅱ组29例30个囊肿，使用改良的高渗葡萄糖注入法，一次或多次注入高渗葡萄糖，使囊肿内葡萄糖的浓度尽量达到50％的高渗环境，并对两组疗效进行对比分析。对所有患者随访6个月及12个月。结果53例均为一次穿刺治疗成功。6个月时I组、Ⅱ组有效率分别为75．00％（18／24）和86．67％（26／30），全部治疗总有效率为81．48％（44／54）；12个月时I组、Ⅱ组有效率分别为58．33％（14／24）和76．67％（23／30），全部治疗总有效率为68．52％（37／54）。两组患者治疗前的囊肿平均直径和容积差异均无统计学意义，但6个月与12个月的治疗有效率差异均有统计学意义（P均do．05）。结论超声引导下经皮穿刺注入高渗葡萄糖治疗肝肾囊肿时，提高囊内葡萄糖的浓度是保证疗效的关键；且此方法操作简便，安全，尤其适宜老年患者。

Ultrasound-guided aspiration and sclerotherapy with 50% glucose for simple cyst of kidney and liver

Objective To evaluate the efficacy of ultrasound-guided aspiration and sclerotherapy with 50% glucose for treatment of simple cyst in liver and kidney.Methods Fifty-three patients of 54 symptomatic cysts in liver or kidney were treated with 50% glucose in different way(group Ⅰ,n=24;group Ⅱ,n=30),and the efficiencies were compared.The cysts in group Ⅰ were injected 50% glucose,the total amount of which was 1/3 volume of cyst liquid aspirated.Cysts in group Ⅱ were treated by modified way,in order to improve the concentration of glucose in cyst as posible,the 50% glucose was injected in to cysts once or many times.The patients were followed up for 6 and 12 months.Results All cysts were successfully treated in one session.Six months later,the total efficiency for all patients was 81.48%(44/54),of groupⅠ and Ⅱwas 75.00%(18/24) and 86.67%(26/30),respectively.The total efficiency of one year for all patients was 68.52%(37/54),of groupⅠ and Ⅱ was 58.33%(14/24) and 76.67%(23/30),respectively.There was no difference of diameter and volume between groupⅠand Ⅱ before treatment,whereas statistical difference of efficiency was found between them affer treatment(all P<0.05).Conclusion Ultrasound-guided aspiration and sclerotherapy with 50% glucose is simple,safe and effective for the treatment of simple cysts of kidney and liver,especially for elder patients.Concentration of glucose in cyst is critical to curative effect.