超声引导下经皮肝穿抽吸硬化介入治疗肝包虫囊肿

Ultrasound-guided percutaneous puncture aspiration and sclerotherapy of liver hydatid cysts

目的探讨超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿的应用价值。方法在超声引导下对38例肝包虫囊肿患者行经皮肝囊肿穿刺抽吸囊液,抽尽后向囊内注入20%～25%无菌高渗盐水或95%无水乙醇,注入量约为抽出量的25%～50%,保留5～15 min后全部抽出,再注入5～10 ml予以保留,术前术后结合口服抗包虫药阿苯达唑30～50mg/kg治疗。术后定期行超声随访,1年内3个月复查1次,1年后每年复查1次。结果治疗中1次穿刺成功率100%,6个月后16例囊肿缩小50%、22例缩小30%。1年后34例治愈,3例显效,1例好转。其后囊肿逐渐缩小,直至钙化,治愈率达100%。结论超声引导下经皮肝穿抽吸硬化治疗肝包虫囊肿是一种安全、有效、可靠的方法。

Objective To investigate the clinical application of ultrasound-guided percutaneous puncture aspiration and sclerotherapy of liver hydatid cysts.Methods Thirty-eight patients of hepatic hydatid cysts underwent ultrasound-guided percutaneous puncture aspiration and sclerotherapy;then 20%—25% septic hypertonic saline or 95% absolute alcohol were injected into the cysts（the volume was about 25%—50% of the aspirated fluid）;and the fluid was reaspirated after 5—15 min.At last,5—10 ml sclerosing agent was injected again.Oral albendazole 30—50 mg/kg was administrated to all patients before and after the above procedures.Ultrasonic follow-up was performed at 3-month interval in the first year and once a year afterwards.Results The successful rate of once puncture was 100%.After 6 months,cysts volume reduced 50% in 16 patients,reduced 30% in 22 patients.One year later,34 patients were cured,3 were effectively treated and 1 was improved.All hydatid cysts volume gradually decreased and calcification occurred.The total cure rate was 100%.Conclusion Ultrasound-guided percutaneous puncture aspiration and sclerotherapy is a safe,effective and reliable treatment of liver hydatid cysts.