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*

doi:10.3969/j.issn.1672-5069.2022.04.029

摘要/Abstract

摘要： 目的探讨在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的疗效。方法 2018年1月～2020年12月我院诊治的巨大单纯性肝囊肿患者73例,随机分为对照组36例和观察组37例,两组均采用在超声引导下穿刺抽液,在对照组注射无水乙醇硬化治疗,在观察组注射聚桂醇置换冲洗硬化治疗。随访6个月。采用化学发光法检测血清C反应蛋白(CRP)和血清淀粉样蛋白A(SAA)水平,采用磁微粒化学发光法检测血清皮质醇(Cor)水平。结果在术后6个月复查,观察组临床总有效率为97.3%,显著高于对照组的80.6%(P＜0.05);治疗前后,两组血清肝功能指标无显著性差异(P＞0.05);在术后1周,观察组血清CRP、Cor和SAA水平分别为(15.7±3.6)mg/L、(283.6±10.3)nmol/L和(13.5±2.4)ng/mL,显著低于对照组【分别为(21.1±4.5)mg/L、(312.3±10.7)nmol/L和(19.8±3.7)ng/mL,P＜0.05】。结论在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有良好的临床治疗效果,且对肝功能的影响小。

关键词: 肝囊肿, 超声引导, 穿刺抽液, 聚桂醇, 硬化治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of percutaneous cather drainage (PCD) under ultrasound (US) guidance with lauromacrogol replacement for sclerotherapy in patients with huge hepatic cysts. Methods A total of 73 patients with huge hepatic cysts were enrolled in our hospital between January 2018 and December 2020, and were randomly divided into control (n=36 and observation group (n=37). The patients in both groups underwent PCD under US guidance, and the patients in the control were given anhydrous ethanol for sclerotherapy, while those in the observation group were given lauromacrogol replacement for sclerotherapy. All patients were followed-up for 6 months after surgery. Serum C-reactive protein (CRP) and serum amyloid A (SAA) levels were detected by chemiluminescence, and serum cortisol (Cor) level was detected by magnetic particle chemiluminescence. Results At the end of 6 month followed-up, the total clinical effectiveness, the disappearance, or largely disappearance, of the cysts, in the observation group was 97.3%, significantly higher than 80.6%(P＜0.05) in the control; there were no significant differences respect to liver function tests between the two groups before and after the surgery (P＞0.05); one week after the operation, serum CRP, Cor and SAA levels in the observation group were (15.7±3.6)mg/L, (283.6±10.3)nmol/L and (13.5±2.4)ng/mL, significantly lower than [(21.1±4.5)mg/L, (312.3±10.7)nmol/L and (19.8±3.7)ng/mL, respectively, P＜0.05] in the control. Conclusion The clinical efficacy of PCD under US guidance with lauromacrogol replacement for sclerotherapy in dealing with patients with huge hepatic cysts is good, with little adverse reactions.

Key words: Hepatic cysts, Percutaneous cather drainage, Ultrasound guidance, Lauromacrogol sclerotherapy, Therapy

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.

Zhang Jing, Lin Ting, Sun Xiang. Percutaneous cather drainage under ultrasound guidance with lauromacrogol replacement for sclerotherapy in patients with huge hepatic cysts[J]. Journal of Practical Hepatology, 2022, 25(4): 571-574.

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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^*

Percutaneous cather drainage under ultrasound guidance with lauromacrogol replacement for sclerotherapy in patients with huge hepatic cysts

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