博莱霉素类药物硬化疗法在囊肿性疾病中的应用

Clinical application of bleomycin sclerotherapy for cystic diseases

博莱霉素类药物硬化疗法已经广泛地应用于治疗各种囊肿性疾病。博莱霉素类药物的致硬化作用机制可推测为早期通过非特异性炎性反应破坏内皮细胞,晚期出现组织纤维化使囊壁塌陷和萎缩。位置浅表的囊肿行博莱霉素类药物硬化疗法时可在直视下进行,实质脏器内或解剖位置复杂的病变则需在影像设备引导下进行;抽尽囊液后注入药物并保留于囊腔内。对淋巴管畸形、肝囊肿、肾囊肿、囊性颅咽管瘤和支气管囊肿等常见囊肿性疾病的总体有效率分别为91.04%～100%、100%、98.5%、73%和100%;并发症轻微,主要为轻度发热、局部疼痛、皮肤溃疡等,均未见严重并发症。

Bleomycins sclerotherapy has been widely used in the treatment of cystic diseases.The sclerosing effect of bleomycins might be speculated that the epithelial destruction was result from the nonspecific inflammatory response in the early stage,and the collapse and shrink of the capsule wall was result from tissue fibrosis in the late stage.Bleomycins sclerotherapy of the superficial cysts can be performed under direct vision,and the treatment of the deep lesions and the visceral cysts must be performed under imaging guidance.As much liquid content of each cyst was aspirated as possible,and bleomycin was injected and remained in the cyst.The overall response rates were 91.04-100%for lymphatic malformations,and 100%for hepatic cysts,and 98.5%for renal cysts,and 98.5%for cystic craniopharyngiomas and 100%for bronchogenic cysts,respectively.The complications were minor,including low-grade fever,localized pain,skin ulcers and so on.No major complications were encountered.