超声引导下聚桂醇硬化治疗单纯性肝囊肿初步研究

目的 探讨超声引导下行聚桂醇硬化治疗单纯性肝囊肿患者的疗效及安全性。方法 2012年3月~2016年10月我院收治的经B超、CT或MRI检查诊断的单纯性肝囊肿患者83例,随机将其分成聚桂醇注射治疗组（n=41）和乙醇注射治疗组（n=42）,分别采用1%聚桂醇或99.7%无水乙醇囊内注射硬化治疗,比较两组术后不良反应、生化指标变化和疗效。结果 聚桂醇和乙醇注射组在年龄、性别、囊肿直径和病程等一般临床资料方面比较,差异无统计学意义（P>0.05）。术后6 m行超声检查,聚桂醇注射治疗组囊肿消失率为39.0%,囊肿缩小率为58.5%,乙醇注射治疗组分别为38.1%和52.4%,两组差异无统计学意义（P>0.05）;聚桂醇注射治疗组术前血清谷丙转氨酶水平为（42.2± 8.1） U/L,术后6月为（34.8± 6.9） U/L,术后较术前有所降低（P<0.05）;乙醇组术前血清谷丙转氨酶水平为（43.4± 9.1） U/L,术后为（35.1± 7.0） U/L,术后较术前同样有所降低（P<0.05）,但两组治疗前后谷丙转氨酶水平和及其肝功能指标差异均无统计学意义（P>0.05）;聚桂醇注射治疗组无醉酒样不良反应发生,而乙醇注射治疗组有6例患者出现醉酒样不良反应,发生率较聚桂醇高（x2=23.11,P<0.01）;聚桂醇注射治疗组腹胀和腹痛发生率为7.3%,显著低于乙醇注射治疗组的23.8%（x2=4.27,P<0.05）;聚桂醇组有4例患者出现发热,3例患者出现恶心呕吐,乙醇组有4例患者出现发热,5例患者出现恶心呕吐,两组在发热和恶心呕吐不良反应发生率方面,差异无统计学意义（P>0.05）。结论 在超声引导下行聚桂醇囊腔内注射能有效治疗单纯性肝囊肿,且与无水乙醇注射比,具有相同的疗效和更少的副作用。作者单位：810007 西宁市 青海省人民医院超声科第一作者：王有全,男,44岁,大学本科,主治医师。主要从事超声疑难病诊断及介入治疗。E-mail： 282424179@qq.com

Efficacy of ultrasound-guided injection of lauromacrogol in the treatment of patients with simple hepatic cyst

【Abstract】 Objective To investigate the efficacy of ultrasound-guided injection of lauromacrogol in the treatment of patients with simple hepatic cyst. Methods A total of83patients with simple hepatic cyst who were confirmed by B ultrasound, computed tomography （CT） or magnetic resonance imaging （MRI） scan were randomly divided into lauromacrogol-intervened group（n=41）, ethanol-injected group（n=42）, and the patients with hepatic cyst received ultrasound-guided injection of lauromacrogol or ethanol, respectively. The efficacy, blood biochemical index, adverse events were assessed between the two group. Result The clinical data at presentation, such as the age of the patients, gender, diameters of hepatic cyst, the duration of the hepatic cyst history, were not significantly different between the two group（P0.05）. The efficacy at the end of six month follow-up showed that there was no significant differences as respect to the disappearance of the cysts, shrunk cysts between the two groups（P0.05）;there were no significant differences in the blood liver function index before, after the inference between the two groups（P0.05）;the incidence of abdominal distension, abdominal pain （x2=23.11, P0.01） as well as drunkenness（x2=23.11, P0.01） was higher in ethanol-injected group, while the incidence of fever, nausea, vomiting showed no significant differences between the two group（P0.05）. Conclusion The ultrasound-guided intracystic injection of lauromacrogol in the treatment of patients with simple hepatic cyst has the same efficacy as the ultrasound-guided injection of ethanol, with less adverse effects