超声引导聚桂醇与无水乙醇硬化治疗单纯性肝囊肿的对比研究

Ultrasound-guided Percutaneous Paracentesis of Polycinnamol and Anhydrous Ethanol in the Treatment of Simple Hepatic Cysts Contrastive Study

目的:对比研究超声引导下经皮穿刺聚桂醇与无水乙醇硬化治疗单纯性肝囊肿的疗效差异。方法:收集我院超声科于2016年9月-2017年12月收治的124例单纯性肝囊肿患者,根据治疗方式不同,将患者分为观察组(n=64)与对照组(n=60),观察组采用超声引导下经皮穿刺聚桂醇治疗,对照组采用无水乙醇注射硬化术,从治疗有效率、不良反应发生率、治疗前后肝功能变化等方面比较两种治疗方式的差异。结果:(1)在术后1个月,观察组与对照组的总体治愈率分别为75.0%、73.3%,在术后6个月,两组患者的总体治愈率分别为90.6%、90.0%,差异均无统计学意义(P>0.05)。(2)与对照组相比,观察组患者腹痛腹胀、恶心呕吐、醉酒样反应的发生率显著较低,差异具有统计学意义(P<0.05),但两组患者发热、出血等不良反应的发生率差异无统计学意义(P>0.05)。(3)两组患者在治疗前,各肝功能指标均差异无统计学意义(P>0.05)。在单发性肝囊肿患者中,术后1周,观察组患者ALT、AST指标显著低于对照组,差异具有统计学意义(P<0.01),在术后6个月,两组患者的所有肝功能指标均差异无统计学意义(P>0.05)。在多发性肝囊肿患者中,术后1周,观察组患者ALT、AST指标显著低于对照组,差异具有统计学意义(P<0.01),在术后6个月,观察组ALT仍然明显低于对照组(P<0.05),其他指标差异无统计学意义。结论:超声引导下经皮穿刺聚桂醇与无水乙醇硬化治疗单纯性肝囊肿均安全有效,但聚桂醇不良反应较少,对肝功能影响较小。当患者存在多发性肝囊肿或肝功能储备不理想时,聚桂醇比无水乙醇更具优势。

Objective：To compare the curative effect of ultrasound guided percutaneous polycinnamol and anhydrous ethanol in the treatment of simple hepatic cysts.Methods：124 cases of hepatic cysts were collected in our hospital from September 2016 to December 2017,according to the different treatment methods,the patients were divided into observation group（n=64）and control group（n=60）,observation group were treated with ultrasound guided percutaneous lauromacrogol treatment,control group using ethanol injection sclerotherapy.From the effective rate,adverse reaction rate differences,comparing two treatments on liver function before and after treatment.Results：（1）In one month after operation,the overall cure rate of the observation group and the control group were 75.0% and 73.3%,respectively.After 6 months,the overall cure rates of the two groups were90.6%and 90.0%,respectively,and the difference was not statistically significant（P〈0.05）.（2）Compared with the control group,the incidence of abdominal pain,abdominal distension,nausea and vomiting and drunken reactions in the observation group were significantly lower than those in the control group（P〈0.05）,but there was no significant difference in the incidence of adverse reactions such as fever and bleeding between the two groups（P〈0.05）.（3）There was no significant difference in liver function indexes between the two groups before treatment（P〈0.05）.After 1 week,the indexes of ALT and AST in the observation group were significantly lower than those in the control group（P〈0.01）.There was no significant difference in all liver function indexes between the two groups at 6 months after operation（P〈0.05）.After 1 week,the ALT and AST indexes of the multiple cysts in the observation group were significantly lower than those in the control group（P〈0.01）.In the 6 months after operation,the ALT in the observation group was still significantly lower than that in the control group（P〈0.05）,but there was no significant difference between the other indexes.Conclusion：Ultrasound-guided percutaneous polyvinyl alcohol and absolute ethanol sclerotherapy for simple hepatic cysts are safe and effective,but the adverse reactions of polycinnamyl alcohol are less,and their liver function is less affected.Polycinnamol is more advantageous than unhydrated ethanol when there are multiple hepatic cysts or poor functional reserves of the liver.