CT引导下经皮双针穿刺治疗骶管囊肿

CT-guided percutaneous injection of the fibrin glue by ＂double needle＂ technique for the treatment of sacral cysts

目的探讨CT引导下经皮双针穿刺注射医用生物蛋白胶（FG）治疗骶管囊肿的安全性和疗效。方法回顾性分析20例CT引导下经皮双针穿刺注射FG，治疗骶管囊肿患者的临床资料。所有患者术前均有明显的腰骶部疼痛等骶神经丛受压症状，诊断明确后，均在传统的CT引导下单针穿刺注射的基础上，行改良的双针穿刺注射FG治疗。注射量3．0～15．0ml，平均（5．9±2．4）ml。治疗后随访1～32个月，平均（17±3）个月。疗效评判标准：优：患者症状完全缓解，可以从事正常1二作，随访1年以上无复发；良：下肢及会阴部症状完全缓解，仅遗留腰骶部疼痛不适，但不影响患者日常工作，随访6个月以上无复发；中：临床症状无改善，但影像检查提示囊肿缩小；差：临床症状无改善，影像检查提示囊肿大小无变化或术后复发。结果所有患者均成功实施治疗，无严重并发症发生。疗效优9例、良8例、中2例、差1例，优良率为85％。4例1个月内症状复发，行再次治疗，症状缓解，但其中1例再次复发。其他患者随访期内未见复发。结论CT引导下经皮双针穿刺注射FG治疗骶管囊肿操作简单、安全可靠。

Objective To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue by ＂double needle＂ technique to treat sacral cyst. Methods Clinical data of 20 cases with ＂double-needle＂ injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed. All patients had varying degrees of sacral nerve root compression symptoms. The treatment for sacral cyst was carried out after clear diagnosis was made. On the basis of CT-guided percutaneous injection of fibrin glue, the improved CT-guided percutaneous injection of fibrin glue by ＂double-needle＂ technique was used to treat these patients. The average dose of fibrin glue was （ 5.9 ± 2. 4） ml. The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months. The assessment criteria were as follows： excellent, complete resolution of signs and symptoms ,with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up, good, symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region, which did not interfere with the patient＇s regular work （the cysts did not recur for 6 months during follow-up）, fair, no improvement in clinical symptoms, but a decrease in cyst size on the imaging study, poor, no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence. Results Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy, with most experiencing complete or marked resolution of clinical symptoms. Nine patients reported excellent recovery,8 reported good recovery, 2 reported fair recovery, and 1 reported poor recovery. The overall percentage of positive outcomes （excellent and good recovery ） was 85% . No serious postoperative complications were discovered. Conclusions CT guided percutaneous injection of the fibrin glue by ＇＂ double needle＂ technique to treat sacral cyst is an ideal method. ＂Double needle＂ technique is simple, safe and reliable.