超声引导下穿刺注射聚桂醇或无水乙醇治疗肝囊肿患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.01.032

摘要/Abstract

摘要： 目的比较在超声引导下穿刺注射无水乙醇与聚桂醇治疗肝囊肿患者的疗效。方法 2020年6月～2022年10月我院收治的肝囊肿患者62例,其中在30例行在超声引导下穿刺注射无水乙醇治疗,在另32例行在超声引导下穿刺注射聚桂醇治疗,随访6个月。采用化学发光法检测血清淀粉样蛋白A(SAA)和C反应蛋白(CRP),采用放射免疫法检测血清皮质醇(Cor)和肾上腺素(E)。结果在治疗后6个月末,超声复查发现无水乙醇治疗组治愈率为96.7%,显著高于聚桂醇治疗组的75.0%(P<0.05);术后3 d复查,无水乙醇治疗组血清SAA、CRP、Cor和E水平分别为(20.7±2.3)mg/L、(35.8±3.8)mg/L、(336.4±24.9)nmol/L和(49.4±6.0)ng/L,均显著高于聚桂醇治疗组【分别为(16.5±2.2)mg/L、(21.9±3.2)mg/L、(282.0±25.9)nmol/L和(39.1±5.3)ng/L,P<0.05】;无水乙醇治疗组醉酒样反应、腹痛、发热和消化道症状等不良反应发生率为43.3%,显著高于聚桂醇治疗组的12.5%(P<0.05)。结论在超声引导下经皮穿刺注射无水乙醇或聚桂醇治疗肝囊肿患者疗效都较好。虽然注射无水乙醇的应激反应较大,但疗效似乎更好,值得进一步研究。

关键词: 肝囊肿, 无水乙醇, 聚桂醇, 超声引导, 硬化治疗

Abstract: Objective The aim of this study was to compare the efficacy of ultrasound-guided injection of absolute ethanol (AE) or lauromacrogol in the treatment of patients with hepatic cysts (HC). Methods 62 patients with HC were enrolled in our hospital between June 2020 and October 2022, and 30 patients out of them were treated with ultrasound-guided injection of AE, and another 32 patients were given ultrasound-guided injection of lauromacrogol. All patients were followed-up for 6 months. Serum amyloid A (SAA) and C-reactive protein (CRP) levels were detected by chemiluminescence, and serum cortisol (Cor) and epinephrine (E) levels were measured by radioimmunoassay. Results The successful disappearance rate of HC in AE-treated patients was 96.7%, significantly higher than 75.0% in lauromacrogol-injected patients (P<0.05); 3 days after injection, serum SAA, CRP, Cor and E levels in AE-treated patients were (20.7±2.3)mg/L, (35.8±3.8)mg/L, (336.4±24.9)nmol/L and (49.4±6.0)ng/L, all significantly higher [(16.5±2.2)mg/L, (21.9±3.2)mg/L, (282.0±25.9)nmol/L and (39.1±5.3)ng/L, respectively, P<0.05] in lauromacrogol-treated patients; the incidence of adverse reactions, such as alcohol-drunken-like reaction, abdominal pain, fever and anorexia in AE-injected patients was 43.3%, much higher than 12.5%(P<0.05) in lauromacrogol-injected patients. Conclusion The intra-cyst injection of AE or lauromacrogol under ultrasound guidance in the treatment of patients with HC is efficacious, and we recommend the AE injection although the AE has a relatively more untoward effects.

Key words: Hepatic cyst, Absolute ethanol, Lauromacrogol, Ultrasound-guidance, Sclerotherapy

贾永利, 王鹏川, 郭伟, 孙东莹. 超声引导下穿刺注射聚桂醇或无水乙醇治疗肝囊肿患者疗效研究^*[J]. 实用肝脏病杂志, 2024, 27(1): 125-128.

Jia Yongli, Wang Pengchuan, Guo Wei, et al. Efficacy of ultrasound-guided injection of absolute ethanol or lauromacrogol in treating patients with hepatic cysts[J]. Journal of Practical Hepatology, 2024, 27(1): 125-128.

参考文献

[1] Yang F, Qian Z, Sun F, et al. Laparoscopic enucleation of hepatic cysts reduces the recurrence of nonparasitic hepatic cysts. J Laparoendosc Adv Surg Tech A, 2021, 31(3):314-319.
[2] Shionoya K, Koizumi K, Masuda S, et al. Liver cyst with biliary communication treated with endoscopic ultrasound-guided drainage: a case report. Medicine (Baltimore), 2022, 101(11):e29007.
[3] 张琼,陈士颖,夏维.超声引导下无水乙醇与聚桂醇硬化治疗单纯性肝囊肿患者效果比较研究.实用肝脏病杂志,2023,26(3):428-431.
[4] Bazayev AV, Kokobelyan AR, Akulenko DS, et al. Criteria for selecting the optimal method of treating hepatic hemangiomas. Sovrem Tekhnologii Med, 2020, 12(1):98-102.
[5] 陈灏珠,林果为.实用内科学.北京:人民卫生出版社,2010:2389.
[6] Mallereau CH, Ganau M, Todeschi J, et al. Relapsing-remitting hepatic pseudo-cyst: a great simulator of malfunctioning ventriculoperitoneal shunt. Case report and proposal of a new classification. Neurochirurgie, 2020, 66(6):461-465.
[7] Wang S, Yin M, Xia Z. Efficacy and preliminary dose studies of ultrasound-guided sclerotherapy with lauromacrogol for the treatment of implanted hepatic tumors in rabbits. J Gastrointest Oncol, 2023, 14(1):265-277.
[8] Shimizu T, Yoshioka M, Kaneya Y, et al. Management of simple hepatic cyst. J Nippon Med Sch, 2022, 89(1):2-8.
[9] 中华医学会超声医学分会介入超声学组,中国研究型医院学会肿瘤介入专业委员会.多脏器囊肿硬化治疗中国专家共识(2021年版).中华超声影像学杂志,2021,30(8):645-654.
[10] Zhu H, Ye L. Comments on "Comparison between two volumes of 70% alcohol in single injection ultrasound-guided celiac plexus neurolysis". Pain Physic, 2022, 25(6):878-880.
[11] 水苗苗,王川予,高侃,等.微波消融与聚桂醇硬化治疗甲状腺囊实性结节的疗效比较.中国医学影像学杂志,2021,29(12):1199-1205.
[12] Yoshida S, Imai H, Roh S, et al. Combined treatment with lymphaticovenular anastomosis and ethanol sclerotherapy for cystic lymphangioma in a limb. Plast Reconstr Surg Glob Open, 2022, 10(5):e4348.
[13] Yang CC, Hsu Y, Liou JY. Efficacy of ethanol ablation for benign thyroid cysts and predominantly cystic nodules: a systematic review and meta-analysis. Endocrinol Metab (Seoul), 2021, 36(1):81-95.
[14] Yu MW, Han YY, Wang Q, et al. Treatment outcomes and effects of ethanol sclerotherapy on systemic coagulation profile of patients with venous malformation. Ann Vasc Surg, 2022, 85(9):268-275.
[15] Z'muda A, Lisiecka U, Dudek K,et al. Phagocytic activity, oxygen metabolism and serum amyloid a concentration in peripheral blood of mink with subclinical aleutian virus infection. Animals (Basel), 2022, 12(8):987-997.
[16] Zekry ME, Sallam AM, AbdelHamid SG, et al. Genetic and epigenetic regulation of MEFV gene and their impact on clinical outcome in auto-inflammatory familial mediterranean fever patients. Curr Issues Mol Biol, 2023, 45(1):721-737.
[17] Watanabe H, Takahara M, Katakami N, et al. Acute effects of whole body vibration exercise on post-load glucose metabolism in healthy men: a pilot randomized crossover trial. Endocrine, 2022, 75(3):752-759.
[18] Zhou W, Wang J, Yang D, et al. Effects of dexmedetomidine on glucose-related hormones and lactate in non-diabetic patients under general anesthesia: a randomized controlled trial. Minerva Anestesiol, 2022, 88(1):8-15.
[19] 江攀,张惠林,刘海,等.超声引导下穿刺硬化治疗肝肾囊肿患者临床疗效研究.实用肝脏病杂志,2022,25(3):439-442.
[20] 吴军,姜凡,蓝晓锋.无水乙醇治疗甲状腺囊性和囊性为主结节的预后影响因素分析.中国超声医学杂志,2021,37(6):601-603.

超声引导下穿刺注射聚桂醇或无水乙醇治疗肝囊肿患者疗效研究^*

Efficacy of ultrasound-guided injection of absolute ethanol or lauromacrogol in treating 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]	李玮健, 刘昕, 舒红艳. 超声引导下聚桂醇与无水乙醇注射硬化治疗肝囊肿患者疗效比较研究^*[J]. 实用肝脏病杂志, 2024, 27(3): 450-453.
[2]	王苓入, 苏虹, 郝晓炜, 李娜. 超声引导下PTGD联合聚桂醇硬化治疗单纯性肝囊肿患者疗效研究^*[J]. 实用肝脏病杂志, 2024, 27(3): 454-457.
[3]	张亚龙, 胡冬梅, 赵晟, 孟海生. 超声引导下射频消融治疗小原发性肝癌疗效及死亡危险因素分析^*[J]. 实用肝脏病杂志, 2024, 27(2): 271-274.
[4]	姜亚超, 尹力, 颜状. “改良三明治夹心法”行ESVD术治疗肝硬化并发食管胃静脉曲张患者疗效研究^*[J]. 实用肝脏病杂志, 2023, 26(6): 863-866.
[5]	徐乔, 李亚娟, 陈惠. 肝囊型包虫病与单纯性肝囊肿患者肝脏MRI表现分析^*[J]. 实用肝脏病杂志, 2023, 26(5): 734-737.
[6]	张琼, 陈士颖, 夏维. 超声引导下无水乙醇与聚桂醇硬化治疗单纯性肝囊肿患者效果比较研究^*[J]. 实用肝脏病杂志, 2023, 26(3): 428-431.
[7]	张静, 林铤, 孙翔. 超声引导下穿刺抽液联合聚桂醇置换冲洗硬化治疗巨大肝囊肿患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 571-574.
[8]	江攀, 张惠林, 刘海, 苏娟. 超声引导下穿刺硬化治疗肝肾囊肿患者临床疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(3): 439-442.
[9]	李文强, 程春霞, 徐冬梅. 腹腔镜开窗引流术与超声引导下穿刺硬化术治疗肝囊肿患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(3): 443-446.
[10]	王欣然, 蒋燕东, 张猛. 超声引导下放射性粒子植入治疗肝细胞癌患者短期疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(2): 263-266.
[11]	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.
[12]	王雪梅, 张瑶, 杨学平, 王玥, 张记. 超声引导下经皮肝穿刺抽脓法和置管引流法治疗艾滋病并发肝脓肿患者临床效果分析[J]. 实用肝脏病杂志, 2021, 24(4): 573-576.
[13]	朱文莉, 李宝新, 张穿洋, 李晓冉, 傅晓明. 肝包虫病与肝囊肿CT表现比较^*[J]. 实用肝脏病杂志, 2021, 24(4): 577-580.
[14]	王琳玲, 周琼, 王月爱. 超声引导下经皮穿刺置管引流联合聚桂醇泡沫硬化治疗单纯性肝囊肿患者疗效研究^*[J]. 实用肝脏病杂志, 2020, 23(6): 909-912.
[15]	郑雪, 宣之东, 王玉, 张丽静. 超声联合CT检查在肝恶性肿瘤射频消融治疗中的应用价值探讨^*[J]. 实用肝脏病杂志, 2020, 23(4): 589-592.