无水乙醇换洗联合医用生物蛋白胶治疗巨大肝囊肿临床观察

Clinical Observation of Absolute Ethanol Sclera-therapy Combined with Injecting Biological Fibrin Glue in the Treatment of Giant Non-parasitic Hepatic Cysts

目的：探讨无水乙醇换洗联合医用生物蛋白胶注射治疗巨大肝囊肿的临床效果。方法：巨大肝囊肿39例均行B超引导下经皮、经肝囊肿穿刺置管术。根据囊肿直径分为3组：A组29例（10～15cm），B组6例（15～20cm），C组4例（〉20cm）。每次注人无水乙醇为A组30～50mL，B组50～80mL，C组80～100mL，换洗3～5次后保留10min至4h后行持续负压吸引，每周治疗2次。当囊肿引流液〈10mL／d并经B超检查囊肿直径3～6cm，注入医用生物蛋白胶5—10mL，后拔除J型管。结果：A组囊肿全部闭合时间为30d，B组为70d，C组4例随访12个月仍未闭，但均明显缩小，直径〈6cm。本组治愈率89．7％，有效率100．0％。结论：B超引导下经皮、经肝穿刺置管无水乙醇换洗联合医用生物蛋白胶治疗巨大肝囊肿方法简单、微创、安全性高、疗效确切。

Objective： To analyze the therapeutic effects of absolute ethanol sclera-therapy combined with injecting biological fibrin glue in giant non-parasitic hepatic cysts. Methods： 39 patients with giant non-parasitic hepatic cysts were treated by percutaneous tube placement under the guidance of ultrasound. Patients were divided into 3 groups according to the cyst diameter. In Group A（ 29 cases） , cyst diameters were from 10 cm to 15 cm,in Group B（6 cases） ,from 15 cm to 20 cm,and in Group C（4 cases） ,more than 20 cm. The amount of absolute ethano injected in Group A was 30 mL to 50 mL,Group B,50 mL to 80 mL and Group C ,80 mL to 100 mL. They took sclera-therapy 3 to 5 times and were kept for 10 rain to 4 hours,and then sucked for ethanol continually until next injection,twice a week. 5 mL to 10 mL of biological fibrin glue were injected before pulling out drainpipe when cyst diameter was 3 cm to 6 cm and drainage was less then 10 mL. Results： In Group A, cysts totally disappeared about 30 days later. In Group B ,they totally disappeared around 70 days later. In Group C ,4 follow-up visits showed that the cysts didnt disappear until 12 months later. However,cyst diameters were smaller than 6 cm. The cure rate was 89.7% and the effective rate was 100.0%. Conclusion： Absolute ethanol sclera-therapy involving injecting biological fibrin glue to treat giant nonparasitic hepatic cysts by percutaneous tube placement under the guidance of ultrasound is simple,effective and minimally invasive.