超声引导下经皮穿刺聚桂醇注射液与无水乙醇硬化治疗单纯性肝囊肿的疗效对比研究

Simple Hepatic Cysts: Comparative Study on Ultrasound-guided Percutaneous Puncture Lauromacrogol Injection and Anhydrous Ethanol Sclerotherapy

目的:探讨并对比超声引导下经皮穿刺聚桂醇注射液与无水乙醇硬化治疗单纯性肝囊肿的疗效。方法:选择2014年5月至2016年9月我院收治的60例单纯性肝囊肿患者为研究对象,按随机数字表法分为两组。实验组30例在超声引导下给予聚桂醇注射液进行硬化治疗,对照组30例在超声引导下给予无水乙醇进行硬化治疗。比较两组患者临床有效率、不良反应发生率;于术前及术后24 h检测并对比两组患者血常规指标水平;于术前、术后1周及术后1月检测并对比两组患者总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、胆碱酯酶(CHE)及白蛋白(ALB)。结果:实验组总有效率为93.33%,对照组总有效率为90.00%,两组总有效率比较,差异无统计学意义(P>0.05)。术前、术后24 h两组各项血常规指标对比,差异均无统计学意义(P>0.05)。与术前相比,术后1周实验组患者血清TBIL、ALT、AST、ALP、CHE及ALB均无明显变化(P>0.05),对照组患者血清ALT和AST升高(P<0.05)。与术后1周相比,术后1个月实验组患者血清ALT、ALP降低,CHE升高(P<0.05),对照组ALT、AST及ALP降低,CHE升高(P<0.05)。术后1周实验组患者血清ALT和AST水平明显低于对照组(P<0.05),TBIL、ALP、CHE及ALB均无明显差异(P>0.05);术后1月实验组患者血清ALT水平明显低于对照组,ALB水平明显高于对照组(P<0.05),TBIL、AST、ALP及CHE均无明显差异(P>0.05)。实验组不良反应发生率为16.67%,低于对照组的30.00%,差异具有统计学意义(P<0.05)。结论:超声引导下经皮穿刺聚桂醇注射液与无水乙醇治疗单纯性肝囊肿均具有较好的疗效,但聚桂醇注射液作为硬化剂的不良反应率明显低于无水乙醇,对肝功能的损伤也较无水乙醇小。因此对于单纯性肝囊肿的硬化治疗,聚桂醇注射液是一种安全有效的硬化剂,值得在临床上推广。

Objective： To compare the clinical efficacy of ultrasound-guided percutaneous puncture lauromaerogol injection and anhydrous ethanol sclerotherapy in the treatment of simple hepatic cysts. Methods： A total of 60 patients with simple hepatic cyst, who were treated in Jinling Hospital Affiliated to Medical School of Nanjing University from May 2014 to September 2016, were enrolled as the subjects and randomly divided into two groups （30 patients in each group）. The experimental group was treated with lauromaerogol injection sclerotherapy under ultrasound guidance. The control group was treated with anhydrous ethanol injection sclerotherapy. The clinical efficacy and the incidence of adverse reactions were compared between the two groups. Blood Routine Indexes of the two groups were measured and compared before operation and 24 hours after operation. The levels of total bilirubin （TBIL）, alanine aminotrans- ferase （ALT）, aspartate aminotransferase （AST）, alkaline phosphatase （AST）, Alkaline phosphatase （ALP）, cholinesterase （CHE） and al- bumin （ALB） of the two groups were measured and compared before operation, 1 week and 1 month after operation. Results： The total effective rate of the experimental group was 93.33%, the total effective rate of the control group was 90.00%, the difference of the total effective rate between the two groups was not statistically significant （P〉0.05）. There was no significant difference in blood test between the two groups before operation and 24 hours after operation（P〉0.05）. Compared with before operation, there were no significant changes in the levels of serum TBIL, ALT, AST, ALP, CHE and ALB in the experimental group 1 week after operation （P〉0.05）, while the serum ALT and AST were increased in the control group （P〈0.05）. Compared with 1 week after operation,the levels of serum ALT and ALP were decreased, but the levels of CHE were increased in the experimental group 1 month after operation （P〈0.05）, while the levels of ALT, AST and ALP in the control group were decrease, but the levels of CHE were increased （P〈0.05）. One week after operation, the levels of serum ALT and AST in the experimental group were significantly lower than those in the control group （P〈0.05）. There were no significant differences in TBIL, ALP, CHE and ALB between the two groups （P〉0.05）. One month after operation, the level of serum ALT in the experimental group was significantly lower than that in the control group, the level of ALB was significantly higher than that of control group （P〈0.05）. There were no significant differences in TBIL, AST, ALP and CHE between the two groups （P〉0.05）. The in- cidence of adverse reactions in the experimental group was 16.67%, which was lower than that in the control group （30.00%）, the differ- ence was statistically significant （P〈0.05）. Conclusion： Ultrasound guided percutaneous puncture of Lanromaerogol Injection and ethanol in the treatment of simple hepatic cysts have a better therapeutic effect,but the adverse reaction rate of lauromacrogol injection is signifi- cantly lower than that of anhydrous ethanol, and the liver functional damage is also less than anhydrous ethanol. Therefore, lauromaerogol injection is a safe and effective hardener in the treatment of simple hepatic cyst sclerotherapy, which is worth popularizing in clinic.