超声引导下分步法硬化治疗高龄巨大肝、卵巢囊肿的临床价值

The Clinical Value of Ultrasound-guided Stepwise Sclerotherapy for Giant Hepatic and Ovarian Cysts in the Elderly

目的:分析超声引导下分步法硬化治疗高龄巨大肝囊肿和卵巢囊肿的临床价值。方法:对海南省文昌市人民医院与沧州市中心医院收治的28例高龄单纯巨大肝囊肿和15例高龄巨大卵巢单纯性囊肿行超声引导下穿刺置管并用50%葡萄糖及无水乙醇进行分步硬化治疗,随访12个月观察其疗效。结果:43例高龄巨大肝囊肿和卵巢囊肿中,最大囊肿容积约14 000mL,最小囊肿容积约2 300mL。随访12个月发现囊肿完全消失或容积缩小80%以上的有31例(72.1%),囊腔容积缩小50%以上的9例(20.9%),囊腔容积缩小50%以下的2例(5%),囊肿增大的1例(2%)。总的治疗有效率为93%,无效率为7%。术中或术后副反应:酒精样反应27例(63%),发热9例(21%),囊腔内出血2例(5%),疼痛11例(26%)。结论:对高龄巨大肝囊肿和卵巢囊肿进行穿刺置管分步硬化治疗的方法创伤小、疗效确切、并发症少,可作为首选的治疗手段。

Objective: To analyze the clinical value of ultrasound-guided stepwise sclerotherapy for giant hepatic and ovarian cysts in the elderly. Methods: 28 cases of simple giant hepatic cyst of the elderly and 15 cases of giant simple ovarian cyst of the elderly received by our hospital and Cangzhou Central Hospital are punctured and catheterized under the guidance of ultrasound and treated by stepwise sclerotherapy with 50% glucose and anhydrous ethanol. The patients are followed up for 12 months to observe the effect. Results: In 43 cases of giant hepatic cyst and ovarian cyst of the elderly, the largest cyst volume is about 14 000 mL, and the smallest cyst volume is about 2 300 mL. It is found that after 12 months of follow-up in 31 cases(72.1%) cysts completely disappear or the volume reduces by more than 80%, in 9 cases(20.9%) the cyst volume reduces by more than 50%, in 2 cases(5%) the cyst volume reduces by less than 50%, and in 1 case(2%) the cyst becomes bigger. The total effective rate of treatment is 93%, and the ineffective rate is 7%. Side effects during or after operation: alcohol reaction in 27 cases(63%), fever in 9 cases(21%), intracapsular hemorrhage in 2 cases(5%), and pain in 11 cases(26%). Conclusion: The method of puncture, catheterization and stepwise sclerotherapy can be used as the first choice for the treatment of giant hepatic cyst and ovarian cyst due to little injury, obvious curative effect and few complications.