介入穿刺引流与外科手术引流治疗肝囊肿患者疗效分析

Short-term curative efficacy of ultrasound-guided cyst puncture,laparoscopic fenestration and laparotomic fenestration drainage in patients with hepatic cysts

目的比较采取不同方法治疗单纯性肝囊肿患者的疗效。方法2017年4月~2019年11月我院收治的单纯性肝囊肿患者117例,接受在超声引导下囊肿穿刺引流和硬化剂注入治疗45例,在腹腔镜下囊肿开窗引流术治疗42例,和开腹囊肿开窗引流术治疗30例,比较治疗疗效。结果穿刺引流和硬化治疗患者痊愈和显效率分别为71.1%和22.2%,腹腔镜治疗组为66.7%和23.8%,开腹治疗组为66.7%和26.7%,三组疗效无显著性差异(P>0.05);治疗后,穿刺引流和硬化治疗组血清ALT、AST和TBIL水平分别为(28.6±4.3)U/L、(28.6±3.9)U/L和(16.4±2.8)μmol/L,腹腔镜治疗组分别为(29.4±3.9)U/L、(29.8±4.0)U/L和(16.8±3.2)μmol/L,开腹治疗组分别为(29.7±3.4)U/L、(28.4±3.7)U/L和(16.2±3.1)μmol/L,三组肝功能指标变化无显著性差异(P>0.05);术后,穿刺引流和硬化治疗组恶性呕吐、腹痛、发热和便溏等并发症发生率分别为15.6%、6.7%、13.3%和4.4%,腹腔镜治疗组分别为21.4%、14.3%、19.0%和7.1%,开腹治疗组分别为23.3%、23.3%、26.7%和6.7%,三组无显著性差异(P>0.05)。结论三种治疗方法治疗单纯性肝囊肿患者临床疗效相当,但在超声引导下穿刺引流和硬化治疗简单、有效,更适合治疗。

Objective The aim of this study was to compare the curative efficacy of ultrasound-guided cyst aspiration,laparoscopic fenestration and laparotomic fenestration drainage in patients with simple hepatic cysts.Methods A total of 117 patients with simple hepatic cysts were admitted to our hospital between April 2017 and November 2019,and out of them,45 cases underwent ultrasound-guided cyst puncture drainage and sclerified,42 cases underwent laparoscopic fenestration drainage and 30 cases underwent laparotomic fenestration drainage.Results The disappearance and effective rates in puncture drainage-treated patients were 71.1%and 22.2%,66.7%and 23.8%in laparoscopic fenestration drainage-treated patients and 66.7%and 26.7%in laparotomic fenestration drainage-treated patients(P>0.05);after treatment,serum ALT,AST and bilirubin levels were(28.6±4.3)U/L,(28.6±3.9)U/L and(16.4±2.8)μmol/L,(29.4±3.9)U/L,(29.8±4.0)U/L and(16.8±3.2)μmol/L,and(29.7±3.4)U/L,(28.4±3.7)U/L and(16.2±3.1)μmol/L,respectively,in the three groups(P>0.05);the incidences of post-operational complications,such as nausea and vomiting,abdominal pain,fever and unformed stool were 15.6%,6.7%,13.3%and 4.4%,21.4%,14.3%,19.0%and 7.1%,and 23.3%,23.3%,26.7%and 6.7%,no significant differences in the three groups(P>0.05).Conclusion The clinical efficacy of the three surgical approaches are similar for patients with simple liver cysts.However,the ultrasound-guided puncture drainage and sclerotherapy is easy and simple way in this setting.