四种不同方法治疗肾囊肿的临床价值

The clinical value in the 4 therapeutic methods of renal cysts

目的探讨不同方法治疗肾囊肿的临床价值.方法回顾性分析2001年4月～2004年3月158例肾囊肿患者的临床资料,其中B超引导下经皮肾穿刺注射无水乙醇硬化治疗48例、后腹腔镜手术治疗86例、小切口手术治疗11例及传统的经腰部切口治疗13例.平均随访时间12个月(3～24个月).随访时间为治疗后1、3、6、12、24个月,B超复查囊肿大小.结果后腹腔镜组创伤小、恢复快、疗效可靠.小切口组创伤较小、医疗费用较低,但手术野暴露较差.传统经腰切口组创伤大,恢复慢但疗效可靠.B超穿刺组安全简便,但远期复发率较高.结论不同方法治疗肾囊肿各有优缺点,腹腔镜手术应列为首选.

Objective To analyze the effect of different treatments of renal cysts, Methods From April 2001 to March 2004, 158 patients with renal cysts in our hospital were treated in four different ways. Among the cases, 48 were treated by ultrasound-guided percutaneous drainage and ethanol sclerotherapy, 86 by retroperitoneal laparoscopic unroofing, 11 by small incision, and 13 by traditional lumbar incision. The mean follow-up were 12（ ranging from 3 to 24 ） months. 1, 3, 6, 12 and 24 months after the treatment, the changes of cysts were checked through ultrasound, Results In the laparoscopic group, the trauma was minor, and the patients recovered quickly, showing the operation was safe and effective. In the small incision group, the trauma was also minor, and the cost was low. However, the visual field in this operation was confined by the size of incision. Traditional lumbar incision could cause more trauma than other methods, and the time of recovery was long, but this method was effective, Ultrasound-guided percutaneous drainage and ethanol sclerotherapy were safe and convenient, but the recurrence rate was high in long time follow-up. Conclusion Each method has its advantages and disadvantages. In clinical practice, laparoscopic surgery might be the best choice for suitable patients,