CT引导下经皮穿刺肝肾囊肿硬化剂治疗

CT-guided Percutaneous Sclerotherapy for Liver and Kidney Cyst

目的探讨CT引导经皮穿刺肝、肾囊肿硬化剂治疗的方法和疗效.方法本组患者均经CT平扫+增强扫描确诊为单纯性肝、肾囊肿,在CT引导定位经皮穿刺肝、肾囊肿内,抽出少量囊液送病检,用1%的利多卡因行囊腔麻醉后,抽净囊液,注入无水乙醇,量为囊液的25%,变化体位保留15～20 min后抽净,再次注入无水乙醇5～10 mL保留.术后分别于3月及6月复查CT扫描对比.结果随访119例,肝、肾囊肿169个,消除138个,有效29个,无效2个,消除率81.7%,有效率98.8%.肝囊肿16例,16个囊肿,治愈率75.00%,随访肾囊肿103例153个囊肿,消除率79.7%,有效率98.7%,除1例肉眼血尿5天,其余病例无严重并发症发生.结论 CT引导下经皮穿刺肾囊肿硬化剂治疗安全有效、准确性高、并发症低,能达到使囊肿缩小以至消失的治疗效果.

Objective To investigate the methods and efficacy of CT-guided percutaneous sclerotherapy for the treatment of liver and kidney cyst. Methods The patients were confirmed by CT scan and enhanced scan diagnosed as simple hepatic or kidney cyst. They were treated with CT-guided percutaneous positioning liver and kidney cyst,and then a small amount of cyst fluid extract was sent to pathological examination. After anesthesia with1% lidocaine,the cyst fluid was extracted and ethanol was injected to the amount of 25% of cyst fluid. Then, fluid was extract after body position changes for 15-20 minutes,and 5-10 mL ethanol was injected again in reserve. CT scan was conducted respectively after operation for three or six months.Results The follow-up 119 cases, liver and kidney cysts occured in 169 cases,among which 138 cysts were eliminated,29 cysts were effective and 2 cysts were invalid,with the elimination rate of 81.7% and efficiency of 98.8%. 16 cases of hepatic cysts showed 16 cysts,and the cure rate was 75.00%. 103 cases with 153 kidney cysts were followed up,and the elimination and efficiency rate was 79.7% and 98.7%, respectively. Except one case of gross hematuria five days, there were no serious complications in the remaining cases.Conclusion CT-guided percutaneous kidney cyst sclerotherapy was safety,effective, high accuracy and low complication, which could achieve narrow therapeutic effect as well as cysts disappear.