腹腔镜下肝囊肿开窗术与超声引导下穿刺介入治疗单纯性肝囊肿患者疗效对比研究

Comparative analysis on laparoscopic fenestration and ultrasound-guided puncture intervention for the treatment of patients with simple hepatic cyst

目的探讨超声引导下穿刺介入治疗与腹腔镜下肝囊肿开窗术治疗单纯性肝囊肿(SHC)患者的疗效。方法2015年6月~2018年3月我院介入超声科和普外科治疗的94例SHC患者被随机分成对照组和观察组,每组47例,分别采取腹腔镜下肝囊肿开窗术和超声引导下穿刺介入治疗。结果术后1个月,两组总有效率均为100%;观察组血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆红素(TBIL)水平分别为(28.4±4.3)U/L、(28.5±2.3)U/L和(18.5±2.4)mmol/L,与对照组的(31.7±4.7)U/L、(31.3±2.4)U/L和(19.9±3.5)mmol/L比,无显著性差异(P<0.05);术后,观察组患者发热、腹胀腹痛和呕吐发生率分别为14.9%、19.2%和25.5%,显著低于对照组的29.8%、42.6%和48.9%(P<0.05)。结论在超声引导下穿刺介入治疗SHC患者,总有效率与腹腔镜下肝囊肿开窗术治疗相当,但创伤小,并发症发生率较低,值得在临床上推广使用。

Objective The aim of this study was to compare the efficacies on laparoscopic fenestration and ultrasound-guided puncture intervention for the treatment of patients with simple hepatic cyst(SHC).Methods 94 patients with SHC were recruited in our Department of Interventional Ultrasound and Department of General Surgery between June 2017 and March 2018,and were randomly divided into control group and observation group,with 47 patients in each group.The patients in the control group were treated with laparoscopic fenestration,and those in the observation group were treated with ultrasound-guided puncture intervention.The liver function tests,adverse reactions and total effective rates were observed and compared between the two groups.Results One month after surgery,the total effective rates in both control group and the observation group were 100%;one month after surgery,serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)in the observation were(28.4±4.3)U/L,(28.5±2.3)U/L and(18.5±2.4)mmol/L,not significantly different as compared to(31.7±4.7)U/L,(31.3±2.4)U/L and(19.9±3.5)mmol/L in the control(P<0.05);after surgery,the incidences of fever,abdominal distension and pain and vomiting in the observation were 14.9%,19.2%and 25.5%,significantly lower than 29.8%,42.6%and 48.9%(P<0.05)in the control.Conclusion The application of ultrasound-guided puncture intervention for the treatment of patients with SHC has the same total effective rate as with laparoscopic fenestration,which might reduce the incidence of adverse reactions,and is worthy for further investigations.