CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿疗效比较

Comparison on the curative effect of CT-guided absolute ethanol replacement and polycinnamyl alcohol hardener in the treatment of parapelvic cysts

目的探讨CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿的临床疗效。方法选择2018年1月至2019年1月在蒲城县医院诊治的104例肾盂旁囊肿患者为研究对象。按照随机单双数法将所有患者分为对照组和观察组各52例。对照组患者予以CT引导下无水乙醇置换术治疗,观察组患者予以CT引导下聚桂醇注射治疗。治疗后6个月,比较两组患者的临床疗效、不良反应及治疗后15个月的复发率,并比较两组患者术前、术后12 h及术后24 h的血清皮质醇(COR)、肾上腺素(AD)、去甲肾上腺素(NE)及血管紧张素(AngⅡ)等应激指标水平。结果观察组患者的临床治疗总有效率为94.23%,明显高于对照组的78.85%,差异有统计学意义(P<0.05);两组患者术后12 h的血清COR、AD、NE及AngⅡ水平均明显高于术前,术后24 h血清COR、AD、NE及AngⅡ水平均明显低于术后12 h,且观察组患者术后24 h血清COR、AD、NE及AngⅡ水平分别为(211.72±21.65)ng/mL、(0.22±0.04)ng/mL、(270.61±27.03)ng/mL、(56.73±5.25)pg/mL,明显低于对照组的(230.73±23.15)ng/mL、(0.31±0.05)ng/mL、(315.38±30.31)ng/mL、(66.80±6.22)pg/mL,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率及复发率分别为7.69%、3.85%,明显低于对照组的36.54%、32.69%,差异均有统计学意义(P<0.05)。结论CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿患者均有一定疗效,但CT引导下聚桂醇注射进行治疗的效果更为显著,对患者造成的应激反应较小,且能明显减少其不良反应及复发。

Objective To investigatethe clinical efficacy of CT-guided absolute ethanol replacement and polycinnamyl alcohol hardener in the treatment of parapelvic cysts.Methods A total of 104 patients with parapyelic cysts who were medically diagnosed and treated in Pucheng County Hospital from January 2018 to January 2019 were selected as the research subjects.According to the random odd and even number method,the patients were divided into a control group and an observation group,with 52 patients in each group.The patients in the control group were treated with CT-guided anhydrous ethanol replacement,and the patients in the observation group were treated with CT-guided polycinnamyl alcohol injection.At 6 months after treatment,the clinical efficacy,adverse reactions,and recurrence rate at 15 months after treatment were compared between the two groups,and the levels of stress indicators such as serum cortisol(COR),adrenalin(AD),norepinephrine(NE),and angiotensin hormone(AngⅡ)were compared between the two groups before operation,12 h after operation,and 24 h after surgery.Results The total effective rate in the observation group was 94.23%,which was significantly higher than 78.85%of the control group(P<0.05);the serum COR,AD,NE,and AngⅡlevels of the two groups at 12 hours after surgery were significantly higher than those at before surgery,and the levels at 24 hours after surgery were significantly lower than those at 12 hours after surgery;the levels of serum COR,AD,NE,and AngⅡat 24 hours after surgery in the observation group were(211.72±21.65)ng/mL,(0.22±0.04)ng/mL,(270.61±27.03)ng/mL,(56.73±5.25)pg/mL,which were significantly lower than(230.73±23.15)ng/mL,(0.31±0.05)ng/mL,(315.38±30.31)ng/mL,(66.80±6.22)pg/mL in the control group(P<0.05).The incidence and recurrence rates of adverse reactions in the observation group were 7.69%and 3.85%,which were significantly lower than 36.54%and 32.69%of the control group(P<0.05).Conclusion Both CT-guided anhydrous ethanol replacement and polycinnamyl alcohol hardener have a certain effect on the treatment of patients with parapelvic cyst,but the CT-guided polycinnamyl alcohol injection has a more significant effect on the treatment of parapelvic cyst patients,causing significantly less stress response to the patients,adverse reactions,and recurrence.