超声引导下套管针穿刺凝血酶联合无水乙醇治疗腘窝囊肿的临床研究

The Clinical Study of Paracentesis Using Trocar and Thrombin Combined with Dehydrated Alcohol in Sclerosing Treatment for Popliteal Fossa Cyst Under Ultrasonographic Guidance

目的探讨超声引导下套管针经皮穿刺凝血酶联合无水乙醇囊内注射硬化治疗月国窝囊肿的方法、疗效和临床应用价值。方法治疗组20例月国窝囊肿患者在超声引导下采用套管针(16G“BD”留置针)进行穿刺、抽吸囊液、α-糜蛋白酶生理盐水溶液冲洗囊腔后,囊内注入无水乙醇进行硬化治疗,1周后抽出囊内渗出液后用凝血酶溶液冲洗囊腔并加压包扎。与对照组(27例)采用18G普通穿刺针穿刺、单纯无水乙醇硬化治疗的月国窝囊肿患者疗效进行比较。结果治疗后采用超声随访6个月以上,治疗组1次治愈17例(85.00%),2次治愈2例(10.00%),3次治愈1例(5.00%),无效0例;对照组1次治愈16例(59.26%),2次治愈8例(29.63%),3次治愈2例(7.41%),无效1例(3.70%)。采用成组设计两样本比较的秩和检验,两种治疗方法差异具有显著性(P<0.05)。结论超声引导下套管针经皮穿刺硬化治疗月国窝囊肿具有微创、安全、有效等优点;凝血酶可明显增强无水乙醇的硬化治疗效果。

Objective To study the methods, efficacy and clinical application value of paracentesis using trocar and thrombin combined with dehydrated alcohol in sclerosing treatment for popliteal fossa cyst （PFC） under ultrasonographic guidance. Methods Ultrasonography-guided percutaneous paracentesis using troear （ 16G Becton Dickinson Vascnlar Access） was performed for 20 cases of PFC in the treatment group, drew out the fluid, washed the cysts with α-chymotrypsin-NS solution, then injected dehydrated alcohol for the selerosing treatment. One week later, drew out the fluid and washed the cysts with thrombin-NS solution, then gave pressure dressing. Compared with 27 PFC cases （the control group） that were treated only with dehydrated alcohol by traditional paracentesis. Results MI the patients were tollowed up for more than 6 months by nltrasonography after the sclerosing treatment. In the treatment gruup, 17 （85.00%）, 2 （ 10.00% ） and 1 （5.00% ） cysts disappeared after 1,2 and 3 times of sclerotherapy respectively and none was ineffective ; In the control group, 16 （ 59.26 % ）, 8 （ 29.63 % ） and 2 （ 7.41 % ） cysts disappeared after 1,2 and 3 times of sclerotherapy respectively and 1 （3.70% } was ineffective. With wilcoxon analysis, significant diference of the therapeutic results existed between the two groups （ P 〈 0.05 ）. Conclusion Paracentesis using trocar guided by ultrasound in the sclerosing treatment of PFC is minimally invasive, safe and effective. Thrombin can enhance the sclerosing effect of dehydrated alcohol.