超声引导肝肾囊肿介入治疗的方法再探

目的对超声引导乙醇治疗肝肾囊肿的方法进行进一步的探讨,使乙醇治疗肝肾囊肿疗效更好,安全性更高。方法采用超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,乙醇总量不予控制为主要方法改进。注重术前认真谈话和彩超引导。结果肝肾囊肿共306个,治愈249个,明显有效48个,有效6个,无效3个。治愈率81.37%,有效率99.02%。其中,肾囊肿189例241个囊肿,有效率100%,治愈率87.55%;肝囊肿59例65个囊肿,有效率95.38%,治愈率58.46%。无一例出现明显的过敏反应、出血等并发症。结论①超声引导下的直接乙醇冲洗疗法和置管引流冲洗疗法,疗效确切,不良反应少。②肾囊肿的治愈率明显高于肝囊肿(P<0.01);大于10mm的肝囊肿疗效差(P<0.01)。③术前认真谈话和彩超引导也很重要。

Re-investigation of interventional therapy of hepatorenal cyst under the guidance of ultrasound

Objective To re-investigate the methods of alcohol therapy of hepatorenal cyst under the guidance of ultrasound and how to improve the curative effects and security. Methods Two hundred and forty-eight patients underwent color Doppler ultrasound-guided interventional therapy because of hepatic cyst or renal cyst. Therapy were performed with alcohol directly washing or tube-placed washing. Results Of the 306 cysts, there were cure in 249 cysts, obvious efficiency in 48 cysts, efficiency in 6 cysts and inefficacy in 3 cysts, the cure rate and effective rate were 81.37% and 99.02%, respectively. Among these patients, there were 189 renal cyst patients (241 cysts), the effective rate and cure rate was 100% and 87.55%, respectively; there were 59 hepatic cyst patients (65 cysts), the effective rate and cure rate was 95.38% and 58.46%, respectively. Besides, there were no obvious anaphylaxis, bleeding, and other complications. Conclusion For the hepatorenal cyst patients, alcohol directly washing or tube-placed washing under the guidance of color Doppler ultrasound is a safe method with explicit effect and little implications. Besides, we find that the cure rate of renal cyst precedes that of hepatic cyst (P<0.01) and the effect of hepatic cyst which is bigger than 10 cm is bad (P<0.01). Furthermore, carefully pre-operation conversation and the color Doppler ultrasound guidance are important.