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

作　　者：贾永利 王鹏川 郭伟 孙东莹 Jia Yongli;Wang Pengchuan;Guo Wei(Department of Ultrasound,People's Hospital,Kaifeng 475000,Henan Province,China)

机构地区：[1]河南省开封市人民医院超声科,475000 [2]河南大学第一附属医院超声科

出　　处：《实用肝脏病杂志》2024年第1期125-128,共4页Journal of Practical Hepatology

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20220649)。

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。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.

关 键 词：肝囊肿 无水乙醇 聚桂醇 超声引导 硬化治疗 

分 类 号：R575.8[医药卫生—消化系统]