CT导引下穿刺置管硬化巨大肝肾囊肿65例的疗效观察  

Curative Effect of CT-guided Puncture and Catheterization Sclerotherapy in the 65 Cases with Giant Hepatorenal Cysts

作　　者：万聚亮 顾丹红 田庆华[1] WAN Ju-liang;GU Dan-hong;TIAN Qing-hua(Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 210306,China)

机构地区：[1]上海交通大学附属第六人民医院放射科,上海210306

出　　处：《中国CT和MRI杂志》2024年第10期91-93,共3页Chinese Journal of CT and MRI

基　　金：上海市卫生健康委员会科研课题计划(202040340)。

摘　　要：目的 探讨CT导引下穿刺置管硬化巨大肝肾囊肿65例的临床疗效。方法回顾性收集2019年1月至2023年1月在我院接受CT导引下穿刺置管硬化治疗的65例巨大肝肾囊肿患者的临床资料。其中肝囊肿31例,肾囊肿34例。所有患者均自愿进行CT导引下穿刺置管硬化术治疗,均随访至术后6个月,观察手术疗效、并发症及复发情况,记录手术前后血常规[红细胞总数(RBC)、血红蛋白(HB)、白细胞总数(WBC)和中性粒细胞百分比(NEUT)]、应激反应[皮质醇(COR)、肾上腺素(AD)和去甲肾上腺素(NE)]、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酸转肽酶(GTP)、总胆红素和直接胆红素]变化情况。结果65例巨大肝肾囊肿患者经CT导引下穿刺置管硬化治疗,均1次穿刺成功。治疗时间21~50min,平均治疗时间(35.13±7.17)min;硬化次数1~4次,平均硬化次数(2.75±0.75)次;住院时间1~3d,平均住院时间(1.98±0.36)d。其中治愈、显效、有效及无效分别31例、24例、6例及4例,总有效率为93.85%。术后24h WBC水平、血清COR、AD和NE水平高于术前,差异有统计学意义(P<0.05)。术后1周,31例巨大肝囊肿患者ALT、AST、GTP、总胆红素和直接胆红素水平均低于术前(P<0.05)。治疗后有1例出血、1例血尿,2例复发。结论CT导引下穿刺置管硬化治疗巨大肝肾囊肿疗效确切,并发症与复发率较少,可以改善患者肝功能水平,但会造成一定应激反应。Objective To explore the clinical curative effect of CT-guided puncture and catheterization sclerotherapy in the 65 cases with giant hepatorenal cysts.Methods A retrospective collection was performed on the clinical data of 65 patients with giant hepatorenal cysts undergoing CT-guided puncture and catheterization sclerotherapy in the hospital between January 2019 and January 2023,including31 cases with hepatic cysts and 34 cases with renal cysts.All patients were voluntarily treated with sclerotherapy and followed up till 6 months after surgery.The surgical effect,complications and recurrence were observed.The changes of blood routine [red blood cell count(RBC),hemoglobin(HB),white blood cell(WBC),neutrophil percentage(NEUT)],stress response [cortisol(COR),adrenaline(AD),norepinephrine(NE)] and liver function indexes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamate transpeptidase(GTP),total bilirubin,direct bilirubin]before and after surgery were recorded.Results In the 65 patients with giant hepatorenal cysts undergoing CT-guided puncture and catheterization sclerotherapy,one-time success rate of puncture100%.The treatment time,average treatment time,sclerotherapy times,average sclerotherapy times,hospitalization time and average hospitalization time were 21-50min,(35.13±7.17) min,1-4times,(2.7510.75) times,1-3d and(1.9810.36) d,respectively.Among the 65 patients,there were31 cases cured,24 cases with obvious effectiveness,6 cases with effectiveness and 4 cases with ineffectiveness,and the total response rate was 93.85%.At 24h after surgery,levels of WBC,serum COR,AD and NE were increased(P<0.05).At 1 week after surgery,levels of ALT,AST,GTP,total bilirubin and direct bilirubin were decreased(P<0.05).After treatment,there was 1 case with hemorrhage,1case with hematuria and 2 cases with recurrence.Conclusion Curative effect of CT-guided puncture and catheterization sclerotherapy is significant in patients with giant hepatorenal cysts,with few complications and low recurrence rate.It can i

关 键 词：巨大肝肾囊肿 CT导引下穿刺置管硬化 聚桂醇 肝功能 应激 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]