彩超引导下聚桂醇一次性硬化治疗巨大肝囊肿的效果和安全性

Application progress of ultrasonic evaluation of tissue changes in lower extremity tenopathy

目的:比较彩色多普勒超声引导下聚桂醇与无水乙醇一次性硬化治疗巨大肝囊肿的效果。方法:回顾性分析2016~2019年天津市北辰医院收治的157例肝脏囊肿患者,根据患者硬化治疗剂不同分为乙醇治疗组和聚桂醇治疗组,比较两组治疗后12个月内囊肿直径缩小程度、症状改善及不良反应情况。结果:乙醇治疗组85例与聚桂醇治疗组72例一般资料差异无统计学意义(P>0.05)。聚桂醇治疗组患者治疗12个月时,囊肿缩小至平均直径4.91 cm(IQR:3.6~10.7 cm),乙醇治疗组治疗的患者在12个月后囊肿缩小至平均为6.7 cm(3.4~6.9 cm),差异无统计学意义(P>0.05)。乙醇治疗组中37例(54.41%)患者症状得到缓解,聚桂醇治疗组38例(66.67%)症状得到缓解,差异无统计学意义(P>0.05)。聚桂醇治疗组患者肝囊肿消失中位时间为6.8个月(95%CI:5.3~8.3)优于乙醇治疗组囊肿消失中位时间9.3个月(95%CI:7.9~10.7),差异有统计学意义(P<0.05)。乙醇治疗组中出现不良事件10例多于聚桂醇治疗组的1例,差异有统计学意义(P<0.05)。结论:彩超引导下聚桂醇一次性硬化治疗肝脏巨大囊肿是一种安全有效的方法,值得进一步研究推广。

Objective To compare the effect of one shot sclerotherapy with poly(cinnamyl alcohol)and absolute alcohol under the guidance of color Doppler ultrasound in the treatment of giant hepatic cysts.Method 157 patients with liver cysts admitted to Tianjin Beichen Hospital from 2016 to 2019 were retrospectively analyzed.According to the different sclerotherapy agents,the patients were divided into ethanol treatment group and polyglycol treatment group.The reduction of cyst diameter,improvement of symptoms and adverse reactions were compared between the two groups within 12 months after treatment.Results There was no significant difference in the general data between the ethanol treatment group(85 cases)and the poly(cinnamyl alcohol)treatment group(72 cases).After 12 months of treatment,the cysts in the poly(cinnamyl alcohol)treatment group shrunk to an average diameter of 4.91 cm(IQR:3.6-10.7 cm),while those in the ethanol treatment group shrunk to an average diameter of 6.7 cm(3.4-6.9 cm),with no significant difference(P>0.05).The symptoms of 37 patients(54.41%)in the ethanol treatment group and 38 patients(66.67%)in the poly cinnamol treatment group were relieved,with no significant difference(P>0.05).The median time of disappearance of liver cyst in the poly cinnamol treatment group was 6.8 months(95%CI:5.3~8.3),which was better than that in the ethanol treatment group[9.3 months(95%CI:7.9~10.7)],with a statistically significant difference(P<0.05).10 cases of adverse events occurred in the ethanol treatment group were more than 1 case in the poly cinnamol treatment group,the difference was statistically significant(P<0.05).Conclusion It is a safe and effective method to treat giant cyst of liver with one shot sclerotherapy of poly(cinnamyl alcohol)under the guidance of color ultrasound,which is worthy of further research and promotion.