囊腔冲洗技术在甲状腺胶质囊肿无水乙醇硬化治疗中的应用

The application of cystic cavity flushing technique in percutaneous ethanol sclerotherapy for thyroid colloid cysts

目的探讨囊腔冲洗技术在甲状腺胶质囊肿无水乙醇硬化治疗中的应用价值。方法 49例甲状腺胶质囊肿随机分配入研究组(33例)和对照组(16例)进行治疗,研究组以0.9%氯化钠溶液混合α-糜蛋白酶冲洗囊腔后行无水乙醇硬化治疗,对照组则单纯抽吸囊液后行无水乙醇硬化治疗。术后1、3、6个月比较两组残存囊腔体积变化、治疗有效率及不良反应情况。结果治疗后残存囊腔体积变化研究组与对照组差别明显,治疗有效率研究组(93.9%)优于对照组(68.8%),差异均有统计学意义(P<0.05);研究组与对照组囊液抽吸冲洗过程均无不良反应发生,两组不良反应均出现在乙醇硬化治疗过程中(6.1%比8.3%),差异无统计学意义(P=0.75)。结论 0.9%氯化钠溶液混合α-糜蛋白酶囊腔冲洗技术应用于甲状腺胶质囊肿黏稠囊液冲洗抽吸是一种安全可靠的方法 ,能提高无水乙醇硬化治疗的效果。

Objective To discuss the application of cystic cavity flushing technique in percutaneous ethanol sclerotherapy for the thyroid colloid cysts. Methods A total of 49 patients with thyroid colloid cysts were randomly divided into the study group （n=33） and the control group （n=16）. Patients in the study group received cystic cavity flushing treatment by using saline together with a-chymotrypsin, which was followed by percutaneous ethanol injection （PEI）. Patients in the control group underwent simple aspiration of cyst fluid followed by PEI. The residual cystic volume, the effective rate and the untoward effects were calculated at one, 3 and 6 months after the treatment, and the results were compared between the two groups. Results Striking difference in the changes of postoperative residual cystic volume existed between the study group and the control group. The effective rate of PEI in the study group was 93.9%, which was obviously better than 68.8% in the control group, the difference between the two groups was statistically significant （P〈0.05）. No untoward effect was observed during the performance of aspiration of cyst fluid and flushing of cystic cavity. Nevertheless, bad side effect occurred in PEI procedure in both the study group （6.1%） and the control group （8.3%）, but the difference was not statistically significant （P=0.75）. Conclusion For the treatment of thyroid colloid cysts, the use of aspiration of cyst fluid together with cystic cavity flushing technique by using saline combined with or-chymotrypsin is safe and reliable, it can improve the curative effect of subsequent PEI.