超声引导下经皮穿刺治疗的临床应用价值

Therapeutic Values of Ultrasound-guided Percutaneous Puncture for Space Occupying Lesions

目的 :探讨超声引导下经皮穿刺治疗各部位占位性病变的临床应用价值。方法 :对 79例各部位占位性病变行超声引导下经皮穿刺治疗。其中 11例为失去手术机会的癌肿病人 ,实行癌肿内直接注射无水乙醇和 (或 )抗癌药物。 5 5例囊性肿块行穿刺抽液注入硬化剂治疗。 6例梗阻性黄疸行超声引导下经皮经肝穿刺胆管引流术。 8例肝脓肿行穿刺置管引流术。结果 :11例失去手术机会的癌肿病人治疗后 1、2年生存率分别为 72 .7% ,45 .5 %。疗效肯定。 5 5例囊性肿块治疗后随访 6个月～3年 ,治愈率达 87.0 % (47/ 5 4) ,总有效率 10 0 % ,其中 1例操作失误未完成治疗。 6例阻塞性黄疸行PTBD及 8例肝脓肿病人穿刺置管引流后临床症状迅速改善 ,疗效显著。结论 :超声引导下穿刺治疗术在各部位占位性病变的治疗中有其独特的临床应用价值 ,值得推广。

Objective: To investigate the therapeutic values of ultrasound-guided percutaneous puncture (UGPP) for space occupying lesions. Methods: Total 79 cases of space occupying lesions were involved in this study. Among of them, 11 cases of patients with nonoperative malignant tumors were treated with directly injecting absolute alcohol or/and anti-cancer drugs into the lesions. 55 cases with cystic mass were treated by the method of withdrawing liquid and sclerosis therapy with puncture. 6 cases of patients with obstructive jaundice were treated by the method of ultrasound-guided percutaneous transhepatic bile duct drainge (PTBD), and 8 cases of patients were hepatic abscess treated by the method of inserting tube drainge. Results: The one year and two years' survival rates of 11 cases of patients with no operation were 72.7% and 45.5% respectively. After the following-up periods of 6 months to 3 years, the cure rate of 55 cases of patients with cystic mass was 87.0%(47/54), and the effective rate was 100%. One case of cystic mass was not succeeded because of mismanipulation. After the treatment, the clinical manifestations of 6 cases of patients with obstructive jaundice treated by PTBD and 8 cases of patients with hepatic abscess treated by the method of inserting tube drainge were rapidly improved. Conclusion: The method of UGPP in the treatment of space occupying lesions is of specifically clinical values.