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*

doi:10.3969/j.issn.1672-5069.2024.03.034

摘要/Abstract

摘要： 目的探讨在超声引导下经皮经肝胆囊穿刺引流术(PTGD)联合聚桂醇硬化治疗单纯性肝囊肿(SHC)患者的疗效。方法 2021年6～2022年8月我院收治的SHC患者67例,采用随机数字表法将其分为观察组34例和对照组33例,两组均行超声引导下PTGD术治疗,只是在对照组给予无水乙醇硬化治疗,在观察组给予聚桂醇硬化治疗。治疗后随访6个月。采用ELISA法检测血清皮质醇(Cor)水平,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)水平。结果在治疗6个月末,观察组总有效率为97.1%,与对照组的93.9%比,无统计学差异(P＞0.05);在治疗后1个月、3个月和6个月末,观察组囊肿体积缩小率分别为(69.1±7.3)%、(84.6±6.9)%和(92.8±3.2)%,显著大于对照组【分别为(56.8±6.4)%、(75.3±5.7)%和(86.3±4.9)%,P＜0.05】;治疗前和治疗后1周,两组血清TBIL、AST、ALT 和ALP水平比较,无显著性差异(P＞0.05);在治疗1周末,观察组血清Cor和SAA水平分别为(260.4±15.6)nmol/L和(13.9±2.1)mg/L,均显著低于对照组【分别为(305.8±18.9)nmol/L和(18.6±2.7)mg/L,P＜0.05】;观察组不良反应发生率为5.8%,显著低于对照组的24.2%(P＜0.05)。结论采用超声引导下PTGD联合聚桂醇硬化治疗SHC患者疗效确切,能有效缩小囊肿体积,缓解应激反应,降低不良反应发生率。

关键词: 单纯性肝囊肿, 经皮经肝胆囊穿刺引流术, 超声引导, 聚桂醇, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) and lauromacrogol sclerotherapy under ultrasound(US) guidance in patients with simple hepatic cysts (SHC). Methods 67 patients with SHC were enrolled in our hospital between June 2021 and August 2022, and were divided randomly into observation (n=34) and control group (n=33). All patients received US-guided PTGD, while the patients in the control group were given anhydrous ethanol for sclerotherapy, and those in the observation group were given lauromacrogol for sclerotherapy. The patients in both groups were followed-for 6 months after treatment. Serum cortisol (Cor) level was detected by ELISA, and serum amyloid A (SAA) and C-reactive protein (CRP) levels were detected by chemiluminescence assay. Results At the end of 6 months after treatment, the total effectiveness rates between the two groups were not statistically significantly different (97.1% vs. 93.9%, P>0.05); at month 1, 3 and 6 after treatment, the reduction rates of cyst volumes in the observation group was (69.1±7.3) %, (84.6±6.9) % and (92.8±3.7) %, significantly greater than those in control group [(56.8±6.4) %, (75.3±5.7) % and (86.3±4.9) %, P<0.05]; there were no significant differences as respect to serum liver biochemical parameters before and one week after the treatment between the two groups(P＞0.05; at the end of one week after treatment, serum Cor and SAA levels in the observation group were (260.4±15.6)nmol/L and (13.9±2.1)mg/L, both significantly lower than [(305.8±18.9)nmol/L and (18.6±2.7)mg/L, respectively, P＜0.05] in the control; the incidence of untoward effects in the observation group was 5.8%, much lower than 24.2%(P＜0.05) in the control group. Conclusion The efficacy of US-guided PTGD and lauromacrogol sclerotherapy is definitely satisfactory in dealing with patients with SHC, which could effectively reduce the cyst volumes, relieve body stress response and reduce adverse reactions.

Key words: Simple hepatic cyst, Ultrasound guidance, Lauromacrogol, Percutaneous transhepatic gallbladder drainage, Sclerotherapy

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.

Wang Lingru, Su Hong, Hao Xiaowei, et al. Disappearance of simple hepatic cysts after percutaneous transhepatic gallbladder drainage and lauromacrogol sclerotherapy under ultrasound guidance: A single center observation[J]. Journal of Practical Hepatology, 2024, 27(3): 454-457.

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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^*

Disappearance of simple hepatic cysts after percutaneous transhepatic gallbladder drainage and lauromacrogol sclerotherapy under ultrasound guidance: A single center observation

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