超声引导聚桂醇注射液与无水乙醇硬化治疗肾囊肿临床效果的对比分析

Comparison of clinical efficacy of percutaneous ultrasound-guided sclerotherapy for simple renal cysts using lauromacrogol and anhydrous ethanol injections

目的:对比和分析聚桂醇注射液与无水乙醇硬化治疗肾囊肿的临床效果和不良反应。方法:回顾性分析江苏省连云港市东海县人民医院72例肾囊肿患者行超声介入硬化治疗的临床效果,聚桂醇组(n=39)和无水乙醇组(n=33)患者均在超声引导下抽尽囊液,分别注入聚桂醇注射液和无水乙醇进行硬化治疗,采用χ2检验比较两组患者的不良反应和术后6个月的疗效。结果:聚桂醇组和无水乙醇组患者手术成功率分别为100%(39/39)和97.0%(32/33)。治疗过程中,聚桂醇组5例诉轻微胀痛,不良反应发生率为12.8%(5/39),显著低于无水乙醇组10例短暂刺激性腹痛和5例持续性腹痛、醉酒样症状等不良反应的发生率(45.5%,15/33)(P<0.05)。术后6个月随访,聚桂醇组治愈率82.1%(32/39),与无水乙醇组治愈率81.8%(27/33)相仿;两组总有效率分别为100%和97.0%,差异无统计学意义(P>0.05)。两组最大径>8 cm肾囊肿的治愈率为56.0%(14/25),显著低于≤8 cm肾囊肿的治愈率100%(47/47)(P<0.05)。结论:聚桂醇硬化治疗肾囊肿的疗效与无水乙醇相仿,其优势是硬化剂可保留在体内,操作简单,不良反应发生率低,患者耐受性好。囊肿大小是影响硬化治疗效果的重要因素。

Objective： To compare and analyze the clinical efficacy of sclerotherapy for simple renal cysts using lauromacrogol and anhydrous ethanol injections under the guidance of ultrasound. Methods： A total of 72 patients with simple renal cysts punctured and treated with sclerotherapy using lauromacrogol injection（n=39） and anhydrous ethanol injection（n=33） under the guidance of ultrasound were retrospectively analyzed. The therapeutic effects and adverse reactions after sixth months were recorded and compared between the two groups. Results： Anatomical success was documented in 100%（39/39） cysts in lauromacrogol group and 97.0%（32/33） cysts in anhydrous ethanol group. During the procedure of sclerotherapy, 5 patients had mild abdominal pain with the incidence of adverse reactions of 12.8%（5/39） in lauromacrogol group, which was significantly lower than that of 45.5%（15/33） in anhydrous ethanol group including 10 patients with transient irritant pain and 5 patients with adverse reactions such as persistent abdominal pain or drunk-like symptoms（P〈0.05）. After six-month follow-up, the cure rate of lauromacrogol group was 82.1%（32/39）, similar with that of 81.8%（27/33） in anhydrous ethanol group; and the overall response rate was 100% and 97.0% in lauromacrogol and anhydrous ethanol groups, respectively（P〈0.05）. The cure rate of renal cyst larger than 8 cm in diameter was 56.0%（14/25）, significantly lower than that of renal cyst no more than 8 cm（P〈0.05）. Conclusion： Sclerotherapy with lauromacrogol injection for renal cysts shows similar perfect outcomes to anhydrous ethanol injection. Lauromacrogol injection is superior to anhydrous ethanol, because it is a retainable agent in the cyst, easily operated, and has less adverse reactions and better patient tolerance. The therapeutic effect of sclerotherapy for renal cysts is greatly influenced by the size of renal cysts.