介入穿刺引流与外科手术引流治疗肝囊肿患者疗效分析*

doi:10.3969/j.issn.1672-5069.2021.05.035

摘要/Abstract

摘要： 目的比较采取不同方法治疗单纯性肝囊肿患者的疗效。方法 2017年4月～2019年11月我院收治的单纯性肝囊肿患者117例,接受在超声引导下囊肿穿刺引流和硬化剂注入治疗45例,在腹腔镜下囊肿开窗引流术治疗42例,和开腹囊肿开窗引流术治疗30例,比较治疗疗效。结果穿刺引流和硬化治疗患者痊愈和显效率分别为71.1%和22.2%,腹腔镜治疗组为66.7%和23.8%,开腹治疗组为66.7%和26.7%,三组疗效无显著性差异(P>0.05);治疗后,穿刺引流和硬化治疗组血清ALT、AST和TBIL水平分别为(28.6±4.3)U/L、(28.6±3.9)U/L和(16.4±2.8)μmol/L,腹腔镜治疗组分别为(29.4±3.9)U/L、(29.8±4.0)U/L和(16.8±3.2)μmol/L,开腹治疗组分别为(29.7±3.4)U/L、(28.4±3.7)U/L和(16.2±3.1)μmol/L,三组肝功能指标变化无显著性差异(P>0.05);术后,穿刺引流和硬化治疗组恶性呕吐、腹痛、发热和便溏等并发症发生率分别为15.6%、6.7%、13.3%和4.4%,腹腔镜治疗组分别为21.4%、14.3%、19.0%和7.1%,开腹治疗组分别为23.3%、23.3%、26.7%和6.7%,三组无显著性差异(P>0.05)。结论三种治疗方法治疗单纯性肝囊肿患者临床疗效相当,但在超声引导下穿刺引流和硬化治疗简单、有效,更适合治疗。

关键词: 单纯性肝囊肿, 超声引导下穿刺引流, 腹腔镜囊肿开窗引流术, 开腹囊肿开窗引流术, 治疗

Abstract: Objective The aim of this study was to compare the curative efficacy of ultrasound-guided cyst aspiration, laparoscopic fenestration and laparotomic fenestration drainage in patients with simple hepatic cysts. Methods A total of 117 patients with simple hepatic cysts were admitted to our hospital between April 2017 and November 2019, and out of them, 45 cases underwent ultrasound-guided cyst puncture drainage and sclerified, 42 cases underwent laparoscopic fenestration drainage and 30 cases underwent laparotomic fenestration drainage. Results The disappearance and effective rates in puncture drainage-treated patients were 71.1% and 22.2%, 66.7% and 23.8% in laparoscopic fenestration drainage-treated patients and 66.7% and 26.7% in laparotomic fenestration drainage-treated patients (P>0.05); after treatment, serum ALT, AST and bilirubin levels were (28.6±4.3)U/L, (28.6±3.9)U/L and (16.4±2.8)μmol/L,(29.4±3.9)U/L,(29.8±4.0)U/L and (16.8±3.2)μmol/L, and (29.7±3.4)U/L, (28.4±3.7)U/L and (16.2±3.1)μmol/L, respectively, in the three groups (P>0.05); the incidences of post-operational complications, such as nausea and vomiting, abdominal pain, fever and unformed stool were 15.6%, 6.7%, 13.3% and 4.4%, 21.4%, 14.3%, 19.0% and 7.1%, and 23.3%, 23.3%, 26.7% and 6.7%, no significant differences in the three groups (P>0.05). Conclusion The clinical efficacy of the three surgical approaches are similar for patients with simple liver cysts. However, the ultrasound-guided puncture drainage and sclerotherapy is easy and simple way in this setting.

Key words: Simple hepatic cyst, Ultrasound-guided puncture drainage and sclerotherapy, Laparoscopic fenestration drainage, Laparotomic fenestration drainage, Efficacy

刘红, 王耀, 胡于凤, 樊建群, 田园. 介入穿刺引流与外科手术引流治疗肝囊肿患者疗效分析^*[J]. 实用肝脏病杂志, 2021, 24(5): 745-748.

Liu Hong, Wang Yao, Hu Yufeng, et al. Short-term curative efficacy of ultrasound-guided cyst puncture, laparoscopic fenestration and laparotomic fenestration drainage in patients with hepatic cysts[J]. Journal of Practical Hepatology, 2021, 24(5): 745-748.

参考文献

[1]尼加提·塔西甫拉提,张新峰,吐尔干艾力·阿吉,等.两种肝囊性疾病的误诊原因分析.中华普通外科杂志,2019,34(10):863-866.
[2]Vardakostas D, Damaskos C, Garmpis N, et al. Minimally invasive management of hepatic cysts: indications and complications. Eur Rev Med Pharmacol Sci, 2018, 22(5):1387-1396.
[3]Wijnands TF, Görtjes AP, Gevers TJ, et al. Efficacy andsafety of aspiration sclerotherapy of simple hepatic cysts: A systematic review. Am J Roentgenol, 2017, 8(1):201-207.
[4]Xu S, Rao M, Pu Y, et al. The efficacy of laparoscopic lauromacrogol sclerotherapy in the treatment of simple hepatic cysts located in posterior segments: a refined surgical approach. Ann Palliat Med, 2020, 9(5):3462-3471.
[5]Lai S, Xu X, Diao T, et al. The efficacy of retroperitoneal laparoscopic deroofing of simple renal cyst with perirenal fat tissue wadding technique: A retrospective study. Medicine (Baltimore), 2017, 96(41):e8259.
[6]Mizumoto Y, Mizuno S, Nakai Y, et al. Cholangitis complicated by infection of a simple hepatic cyst. Clin J Gastroenterol, 2018, 11(6):493-496.
[7]王有全. 超声引导下聚桂醇硬化治疗单纯性肝囊肿初步研究.实用肝脏病杂志,2017,20(6):748-751.
[8]Allan M, Asimakidou M, Davenport M. Antenatally-detected liver cysts: Causes and characteristics, indications for intervention. J Pediatr Surg, 2020, 55(3):441-445.
[9]Sekiguchi T, Hirose S, Hara T, et al. Complications duringsclerotherapy for symptomatic hepatic cysts: Successful bailout for penetrating the hepatic artery and portal vein. J Vasc Interv Radiol, 2019, 30(7):1048-1049.
[10] Suzuki T, Kutsuna S, Tsuboi M, et al. Helicobacter cinaedicepatic cyst infection with bacteremia. Emerg Infect Dis, 2019, 25(3):603-604.
[11] Mizumoto Y, Mizuno S, Nakai Y, et al. Cholangitis complicated by infection of a simple hepatic cyst. Clin J Gastroenterol, 2018, 11(6):493-496.
[12] Reissis Y, Burkhart R. Hemorrhagichepatic cysts: Diagnosis and management. Am Surg, 2020, 86(3):e127-e129.
[13] Zhang C, Ma YF, Yang YL. Jaundice caused by protrusion of a hepatic cyst into common bile duct that was resolved by choledochoscopic needle-knife electrotomy: a case report. BMC Gastroenterol, 2018, 18(1):90-95.
[14] 李甜甜,白亮亮,周乃春,等.影像引导下穿刺硬化术与腹腔镜下开窗引流术治疗非寄生虫性肝囊肿:Meta分析.中国介入影像与治疗学,2018,15(8):473-476.
[15] Zhang JY, Liu Y, Liu HY, et al. Comparison of the recurrence rates of nonparasitic hepatic cysts treated with laparoscopy or with open fenestration: A meta-analysis. Surg Laparosc Endosc Percutan Tech, 2018, 28(2):67-72.
[16] Linden AF, Pulcrano ME, Duffy BJ, et al. Laparoscopic excision of congenital hepatic cysts in the pediatric population: A case series and literature review. J Laparoendosc Adv Surg Tech A, 2016, 26(6):493-497.
[17] Furumaya A, van Rosmalen BV, de Graeff JJ, et al. Systematic review on percutaneous aspiration and sclerotherapy versus surgery in symptomatic simple hepatic cysts. HPB (Oxford), 2020, S1365-182X(20):31096-31100.
[18] Wijnands TF, Ronot M, Gevers TJ, et al. Predictors of treatment response following aspiration sclerotherapy of hepatic cysts: an international pooled analysis of individual patient data. Eur Radiol, 2017, 27(2):741-748.
[19] Jang SY, Park SY, Tak WY, et al. Long-term follow-up of large symptomatic hepatic cysts treated by percutaneous ethanol sclerotherapy. Acta Radiol, 2016, 57(10):1205-1209.
[20] Vardakostas D, Damaskos C, Garmpis N, et al. Minimally invasive management of hepatic cysts: indications and complications. Eur Rew Med Pharmacol Sci, 2018 Mar;22(5):1387-1396.

介入穿刺引流与外科手术引流治疗肝囊肿患者疗效分析^*

Short-term curative efficacy of ultrasound-guided cyst puncture, laparoscopic fenestration and laparotomic fenestration drainage in patients with hepatic cysts

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	汤磊, 邹桂舟. 外科疾病导致的胆源性肝损伤诊治现状[J]. 实用肝脏病杂志, 2021, 24(6): 769-771.
[2]	姜浩, 张雯, 陈霞. 长效干扰素联合利巴韦林治疗慢性丙型肝炎患者疗效及其对静息能量消耗和营养状态的影响^*[J]. 实用肝脏病杂志, 2021, 24(6): 815-818.
[3]	黄飞虎, 薛建亚, 朱咏梅, 余姣, 王丽艳, 鲁琼. 应用索磷布韦/维帕他韦治疗门诊和住院筛查的丙型肝炎患者疗效研究[J]. 实用肝脏病杂志, 2021, 24(6): 819-822.
[4]	肖金玉, 王延峰, 文小霞. 自身免疫性肝炎患者血清趋化因子CCL4和CXCL10水平及其临床意义探讨[J]. 实用肝脏病杂志, 2021, 24(6): 827-830.
[5]	杜云飞, 刘景瑞, 叶飞翔. N-乙酰半胱氨酸联合双环醇治疗抗结核药物所致的药物性肝损伤患者疗效研究^*[J]. 实用肝脏病杂志, 2021, 24(6): 847-850.
[6]	刘玉玲, 甄增国, 王慧娟, 万秀敏, 郭振凯. 益生菌制剂对肝硬化并发自发性细菌性腹膜炎患者肠道屏障功能的影响^*[J]. 实用肝脏病杂志, 2021, 24(6): 867-870.
[7]	黄力鸥, 吴春荣, 徐丹, 崔宇慧, 唐建国. 无肝素化连续性肾脏替代治疗肝硬化并发肝性脑病患者疗效研究^*[J]. 实用肝脏病杂志, 2021, 24(6): 875-878.
[8]	王菁, 毕宁, 方亮, 田园. 自体骨髓干细胞经肝动脉肝内移植治疗失代偿期乙型肝炎肝硬化患者疗效研究[J]. 实用肝脏病杂志, 2021, 24(6): 887-890.
[9]	束青华, 张楠楠, 葛勇胜. 不同HCV基因型感染的慢性丙型肝炎和肝硬化患者对重组人干扰素α-2a治疗应答的影响[J]. 实用肝脏病杂志, 2021, 24(6): 899-902.
[10]	俞士刚, 田佳, 吴铁, 樊书荣. 损伤控制性手术对创伤性肝破裂患者生存及相关应激指标的影响^*[J]. 实用肝脏病杂志, 2021, 24(6): 915-918.
[11]	蔡创, 范若英, 李伟, 吴胜, 田宇剑, 唐晓明, 金勇, 周城臣. 十二指肠乳头旁憩室对ERCP手术治疗胆总管结石患者效果的影响^*[J]. 实用肝脏病杂志, 2021, 24(6): 919-922.
[12]	梁晨, 郑素军. Wilson病治疗研究现状^*[J]. 实用肝脏病杂志, 2021, 24(6): 930-933.
[13]	李伟之, 李培杰, 马富权, 刘梦莹, 薛挥. 应用利伐沙班抗凝治疗经皮血管内介入治疗的布加综合征患者疗效和安全性研究^*[J]. 实用肝脏病杂志, 2021, 24(5): 621-624.
[14]	李伟, 宋卫东, 谢巴图白音. 采用EVL或TIPS治疗肝硬化并发食管静脉曲张出血患者疗效及其预后分析^*[J]. 实用肝脏病杂志, 2021, 24(5): 629-632.
[15]	季旻游, 李超, 赵兴忠, 武煦峰. 恩替卡韦联合复方甘草酸苷治疗乙型肝炎肝硬化患者疗效及对肠道菌群的影响^*[J]. 实用肝脏病杂志, 2021, 24(5): 641-644.