良性肾囊性病变的介入超声硬化治疗(附1581例报告)

Interventional ultrasonic sclerotherapy for benign renal cystic diseases:report of 1 581 cases

目的评价介入超声硬化疗法治疗良性肾囊性病变的远期疗效。方法对1581例良性肾囊性病变（单纯性肾囊肿1544例、多囊肾32例、肾囊肿合并囊内感染5例）采用实时超声引导穿刺硬化治疗,对直径〉7 cm及囊内积脓者治疗后保留套管持续引流。结果单纯性肾囊肿中1426例治疗后随访2年,107例随访6个月,1155例囊肿完全消失、无复发;378例残囊直径小于3 cm,无继续增大。32例多囊肾随诊27例,治疗后9-27个月内肾功有不同程度改善及未继续恶化者19例,8例终末期患者肾功衰竭。5例肾囊肿合并囊内感染者治愈,治疗后2年无复发。本组治疗后无严重并发症。结论介入超声硬化疗法治疗良性肾囊性病变,简便、安全、有效、经济,仍值得推荐首选应用。

Objective To evaluate the prostecdtive efficacy of interventional ultrasonic sclerotherapy for the treatment of benign renal cystic diseases. Methods One thousand five handred eighty-one cases of benign renal cystic diseases （ 1 544 cases of simple renal cysts, 32 cases of adult polycystic kidney disease,5 cases of renal cyst complicating infeetio）underwent pereutaneous puncture and sclerotherapy by real-time uhrasonic guidance. After the treatment,the intracystic catheters were preserved in the cysts beyond 7 cm in diameter and the infected cysts followed by persistent drainage. Results One thousand four hundred twenty-six cases and 107 cases of simple renal cysts were followed up 2 years and 6 months respectively after treatment. Among them,1 155 cysts completely disappeared without reoccurrence, and 378 cases of reliquus renal cysts beyond 3 cm in diameter did not grow afterward. Twenty seven cases of adult polycystic kidney disease were followed up 9 - 27 months. For 19 cases of them, the renal function was improved gradually in different degrees, no significant deterioration occurred, and the other 8 cases with final stage of renal failure had no improvement. Five cases of renal cyst complicating infection did not recur 2 years after treatment. There was no severe morbidity in all patients after treatment. Conclusions It suggests that interventional ultrasonic sclerotherapy is simple, safe, effective and inexpensive, and still be recommended as the first-choice procedure in the treatment of benign renal cystic diseases.