超声引导下穿刺介入治疗肝囊肿远期疗效观察  

Clinical Investigation of Long-term Therapeutic Effect of Ultrasound-guided Interposing Puncture for Hepatic Cysts

作　　者：安树章[1] 边秋平[1] 姚希贤[2] 王香琢 赵淑敏[4] 刘永刚[1] 齐建立[1] 杨玉亮[1] 

机构地区：[1]河北105医院,河北定州073000 [2]河北医科大学第二医院,河北石家庄050000 [3]保定市第三医院,河北保定071000 [4]承德医学院,河北承德067000

出　　处：《成都医药》2002年第1期13-16,共4页

摘　　要：目的 :探讨在超声引导下经皮穿刺介入硬化治疗肝囊肿的 5年远期临床疗效。方法 :动物实验应用四环素与氟美松组合硬化剂注入家兔胆囊 ,与生理盐水和无水乙醇对比观察其对胆囊壁的作用 ;临床应用与无水乙醇对比观察介入硬化治疗肝囊肿的远期疗效。结果 :动物实验、生理盐水组胆囊上皮均无组织学异常改变 ;无水乙醇组胆囊内出血渗液多 ,吸收慢 ,纤维组织增生少 ;组合硬化剂组胆囊内渗液少 ,吸收快 ,纤维组织增生明显。临床治疗肝囊肿 ,组合硬化剂具有刺激囊肿内渗液量少 ,囊腔闭合快 ,治愈率高 ,无复发的优点。 1年、 3年、 5年治愈率分别为 93 5 %、 98 1%、98 1% ,而无水乙醇组分别为 6 5 5 %、 86 4 %、 87 3% ,两组间比较均有显著性差异 (P <0 0 1、 <0 0 5、 <0 0 5 )。 5年观察组合硬化剂组无复发 ,无水乙醇组有 9例 (8 2 % )复发 (P <0 0 5 )。结论 :组合硬化剂序贯应用 ,先期药物大剂量高浓度硬化与保留药物促进囊肿内渗液吸收相结合的方法 ,较好地克服了无水乙醇硬化剂的缺点 ,具有良好的远期临床疗效。Objective:To explore the long-term of 5 years therapeutic effect of ultrasound-guided percutaneous interposing puncture for hepatic cysts using sclerosing complex agents(SCA).Methods:In animal experiment,the SCA containing tetracycline and dexamethasone,was injected into the gallbladder of rabbits,compared its action with normal saline and absolute ethylalcohol on the gallbladder wall.The therapeutic effects of SCA and absolute ethylalcohol in hepatic cysts were observed.Results:In animal experiment,there ws no abnormal histologic change in normal saline group.But in absolute ethylalcohol(AE)group,a large amount of oozing liquid and blood appeared,the absorption process was slow,and the fiber tissues had scarce proliferation.In SCA group,there was less oozing liquid,no blood in the gallbladder,and the absorption was active,and the fiber tissues hyperplasia obviously.In clinical practice,SCA possesses many advantages in the treatment of hepatic cysts,by which the cysts closed quickly,the exudation reduced,and no relapse occurred.The first,third and fifth year cure rates were 93.5%,98.1%,98.1%;but in the AE group were 65.5%,86.4%and 87.3%,respectively,the difference being( P <0.01,<0.05,<0.05)significant.After fifth years,no relapse occurred in the SCA group,but 9(8.2%)cases relapsed in the AE group( P <0.05).Conclusion:The sclerosin agents should be used in sequence,i.e.,a high concentration was administered to reduce and destroy the epithelium of the cysts,and to promote fiber tissue adhesion and then the remaining drug was used to stimulate epithelium to absorb the exudation.The combined regimen was proved to be an ideal and effective method for treating hepatic cysts clinically and to have good long-term curative effects.

关 键 词：肝囊肿 超声引导穿刺 硬化治疗 组合硬化剂 介入治疗 远期疗效 

分 类 号：R575[医药卫生—消化系统] R735.7[医药卫生—内科学]