改良后的超声介入治疗盆腔囊肿的疗效分析

Curative Effect Analysis of Improved Interventional Ultrasound in the Treatment of Female Pelvic Cyst

目的:探讨经改良后的超声引导下无水乙醇硬化治疗盆腔囊肿的应用价值。方法:将299例盆腔囊肿患者随机分成3组:A组(72例)在超声引导下使用PTC针抽净囊液后,注入<1/2抽出囊液量的无水乙醇(最多不超过100 mL),静置5 min-10 min后抽净注入液,最后囊腔永久保留5 mL^10 mL无水乙醇;B组(103例)在A组的基础上,使用无水乙醇反复多次对囊腔进行硬化治疗,最后抽净注入液;C组(124例)在超声引导下穿刺置入Skater 6F^12F引流管抽净囊液后,注入>1/2抽出囊液量的无水乙醇(最大量控制在150 mL),然后利用"加压快速注射法"、"多体位注射法"对囊腔进行硬化治疗,24h后拔出留置引流管。观察分析3组患者术后12个月的疗效及并发症发生情况。结果:A组术后并发症发生率29.8%(25/84),B组术后并发症发生率15.7%(19/121),C组术后并发症发生率6.4%(9/141),3组并发症发生率间差异有统计学意义(P<0.01);C组和A、B组并发症发生率间差异均有统计学意义(P<0.05)。治疗后12个月,3组患者疗效间差异有统计学意义(P<0.01)。3组囊肿直径<12 cm的患者,术后12个月疗效间差异有统计学意义(P<0.05);而囊肿直径≥12 cm的患者,3组疗效间差异无统计学意义(P>0.05)。结论:在用量上采用"大剂量法",在方法上采用"加压快速注射法""多体位注射法"以及在时间上采用"留置引流24 h"的改良后超声引导下无水乙醇硬化治疗盆腔囊肿安全、有效,减少复发率及并发症的发生。

Objective： To explore the clinic value of improved intervention with ethanol sclerotherapy under the guidance of Color Doppler ultrasound in the treatment of pelvic cyst. Methods： 299 cases of pelvic cyst patients were randomly divided into three groups. Group A（72 patients）, after the liquid was drawn out with the PTC needle under the guidance of ultrasound, absolute ethanol of less than half of the drawn liquid（ maximally 100ml） was injected into the cyst, then the ethanol was drawn out after 5 to 10 minutes later and retained 5 to 10 ml permanently. Group B（103 patients）, based on the treatment of group A, were given absolute ethanol inject into cyst repeatedly, finally the injected ethanol was drawn out. Group C（124 patients）, after the liquid was drawn out with Skater 6F～12F under the guidance of ultrasound, were given absolute ethanol of more than half of the drawn liquid（maximally 150 ml）, then the therapy was given for the cyst with＂pressurized rapid injection method＂and＂multi-postural injection method＂, pull out the drainage tube after24 hours. The effects 12 months after surgery and complications among the three groups were compared. Results： The incidence rate of complications was respectively 29.8%（25/84） in Group A, 15.7%（19/121） in Group B, 6.4%（9/141） in the Group C, with a significant difference among the three groups（P〈0.01） the incidence rates of complications in Group C were significantly different from Group A and B（P〈0.05）. Twelve months after surgery, the effects among the three groups showed significant difference（P〈0.01）. The effects of the patients whose cyst＇s diameter 〈12 cm among the three groups showed significant difference（P〈0.05）; while the effects of the patients whose cyst＇s diameter≥12 cm among the three groups showed no significant difference（P〉0.05）. Conclusion： The improved absolute ethanol intervention, being ＂High-dose method ＂in dosage＂, ＂pressurized and rapid injection method＂, ＂Multi-postural injection method＂ in operation and ＂24h catheter-basic drainage＂ in time, has been more scientific and rational, safe and effective, which could reduce the relapse rate and complications.