彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿

Color ultrasound guidance sclerotherapy with polidocanol for children with simple renal cysts

目的探讨彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿临床疗效，寻找小儿单纯性肾囊肿有效的治疗方法及合适的应用药物。方法回顾2011年5月至2014年10月我院经彩色超声、CTU明确诊断为单纯性肾囊肿患儿51例，其中28例为聚桂醇治疗组，采用彩色超声引导下经皮穿刺并注入聚桂醇，无水乙醇灌洗法23例设为对照组，对比两组不良反应发生情况及治疗后1年两组疗效情况。结果51例患儿均穿刺注药成功，治疗后3个月、6个月、1年均获彩色超声随访，聚桂醇治疗组治愈率为85.7%，有效率为92.9%，均高于无水乙醇组的60.9%和65.2%，差异均有统计学意义（P〈0.05）；聚桂醇治疗组患儿异常哭闹及面红例数均明显较对照组少，差异有统计学意义；聚桂醇治疗组无一例肉眼血尿发生，对照组有6例治疗后出现肉眼血尿，辅助应用止血药物后，均在3 d之内消失，差异有统计学意义（P〈0.05）；聚桂醇治疗组患儿仅1例出现穿刺后发热，对照组治疗后9例出现发热，差异有统计学意义（P〈0.05）；治疗组患儿穿刺点渗血及呕吐例数均较对照组少，差异均有统计学意义（P〈0.05）。聚桂醇治疗组二次穿刺例数及手术例数均较无水乙醇组少。结论彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿疗效确切、副作用小，应作为小儿单纯性肾囊肿首选治疗方案。

Objective To explore the efficacy and safety of color ultrasound guidance sclerotherapy with po!idocanol for children with simple renal cysts. Methods A total of 43 children with simple renal cysts were analyzed. The diagnosis was confirmed by computed tomography urography （CTU） and color Doppler ultrasound. Sclerotherapy was performed with ethanol in 23/51 cases （45%） and polidocanol in 28/51 （55%）. Contrast complications and efficacies were compared after 1 year. Results Color ultrasound guidance sclerotherapy was performed. Follow-ups of color ultrasound were conducted at 3, 6 and 12 months respectively. The successful outcome ratio of the polidocanol group was significantly higher than that of the ethanol group （P〈0. 05）. The curative rates were 85. 7% vs 60. 9% and effective rates 92. 9% vs 65.2% respectively. Abnormal crying and facial flushing were less frequent in the polidocanol group than the control group. The polidocanol group had no macroscopic hematuria. In the control group, 6 post-therapeutic cases of macroscopic hematuria recovered after a dosing of hemostatic drugs within 3 days. And the difference was statistically significant （P〈0. 05）. Only I case of fever was reported in the polidocanol group while 9 cases were feverish in the control group. And the difference was statistically significant （P〈0. 05）. Puncture point errhysis and vomiting were less frequent in the polidocanol group than those in the control group. And the difference had statistical significance （P 〈 0. 05 ）. Conclusions Color ultrasound guidance sclerotherapy with polidocanol is both safe and effective for children simple renal cysts. And it should be a preferred option.