B超引导下经皮肝穿刺注射无水酒精治疗肝囊肿的疗效观察

发布时间：2018-05-15 23:41

本文选题：单纯性肝囊肿 + 无水酒精　；参考：《石河子大学》2014年硕士论文

【摘要】：目的：探讨B超引导下经皮肝穿刺注射无水酒精硬化治疗单纯性肝囊肿的方法，评价该治疗方法的临床疗效及临床应用价值，最大努力确保B超引导下经皮肝穿刺注射无水酒精硬化治疗单纯性肝囊肿的有效性、安全性，为进一步提高通过此方法治疗单纯性肝囊肿的疗效、降低术中、术后并发症的发生率，总结临床经验，从而更好地在临床工作中展开推广。方法：收集石河子大学医学院第一附属医院2008年1月-2013年6月单纯性肝囊肿患者病例80例，所有病例均采用超声引导下经皮肝穿刺注射无水酒精硬化治疗，且均为第1次治疗。治疗结束后随访观察治疗情况，随访时间为3-6个月，复查腹部B超，以4级疗效指数办法对疗效进行判断，以术中、术后是否出现腹痛、酒精反应、出血、感染作为疗法安全性观察指标，对治疗要点和术中并发症发生情况进行分析，通过随访观察，评价疗效及分析治疗情况。结果：收集80例单纯性肝囊肿患者均成功穿刺，抽出囊液为无色或黄色清亮。80例单纯性肝囊肿患者中穿刺治疗1次77例，2次2例，3次1例，其中行3次无水酒精硬化治疗者囊肿直径为12.1cm×10.3cm，治疗过程顺利，穿刺间隔时间为1周，治疗过程中及结束后观察患者无明显不适症状。80例单纯性肝囊肿患者治疗术后总有效率：随访3个月95%，随访6个月97.5%。治疗术后治愈率：随访3个月65%，随访6个月80%。共2例患者复发，，复发率为2.5%，治疗效果显著。手术操作过程顺利，与患者详细沟通后80例患者均配合良好，术中未出现一例严重并发症，治疗80例单纯性肝囊肿患者共有18例出现轻度腹痛，1例患者出现酒精反应，经密切观察后均自行缓解，未出现其他严重并发症。结论：（1）有效通过对本课题研究所收集的病例进行分析，总结出经皮肝穿刺注射无水酒精治疗单纯性肝囊肿3个月治愈率为65%，总有效率为95%，复发率为2.5%；6个月的治愈率为80%，总有效率为97.5%，复发率为2.5%，认为此方治疗单纯性肝囊肿有效、可行。（2）安全、简便本课题所研究的B超引导下硬化治疗单纯性肝囊肿的手术方式在局部麻醉及超声动态观察下进行治疗，操作过程精确，术中、术后未出现一例严重并发症。（3）费用低此治疗方法手术费用远低于外科手术治疗，患者经济负担小，绝大多数患者能予以很好的配合（4）创伤小B超引导下无水酒精硬化治疗单纯性肝囊肿是一种微创手术，同时其手术伤口小，降低了术后伤口感染率，已取代了外科创伤性手术治疗，其适用人群更为广泛。（5）恢复快患者在术后第二天即可下地行走，不影响患者正常生活。
[Abstract]:Objective: to evaluate the clinical efficacy and clinical value of percutaneous ethanol sclerosis under B-ultrasound guidance in the treatment of simple hepatic cysts. The best efforts were made to ensure the efficacy and safety of percutaneous ethanol injection under the guidance of B-ultrasound in the treatment of simple hepatic cysts. In order to further improve the efficacy of this method in the treatment of simple hepatic cysts, and reduce the intraoperative efficacy, The incidence of postoperative complications, summarized clinical experience, so as to better spread in the clinical work. Methods: 80 patients with simple hepatic cyst were collected from the first affiliated Hospital of Shihezi University Medical College from January 2008 to June 2013. All the patients were treated with percutaneous injection of anhydrous alcohol sclerosis under the guidance of ultrasound for the first time. The treatment was followed up for 3-6 months after the treatment. Abdominal B-ultrasound was re-examined and the curative effect was judged by the method of 4-grade curative effect index. Whether abdominal pain, alcohol reaction, bleeding occurred during or after the operation, or not, was determined by the method of grade 4 curative effect index. Infection was used as a safety observation index to analyze the main points of treatment and the occurrence of intraoperative complications. Through follow-up observation, the curative effect and treatment were evaluated and analyzed. Results: 80 cases of simple hepatic cyst were successfully punctured. The extraction fluid was colorless or yellow clear. In 80 cases of simple hepatic cyst, 77 cases were treated once, 2 cases were treated twice, 2 cases were 3 times, 1 case. The diameter of cysts was 12.1cm 脳 10. 3 cm after 3 times of anhydrous alcohol sclerotherapy. The procedure was smooth, and the interval between puncture and puncture was 1 week. The total effective rate of 80 patients with simple hepatic cyst after treatment was 95% for 3 months and 97. 5 for 6 months. The cure rate was 65% for 3 months and 80% for 6 months. There were 2 cases of recurrence, the recurrence rate was 2.5%, and the therapeutic effect was remarkable. The operation was smooth, 80 patients had good cooperation after detailed communication with the patients, no serious complications occurred during the operation, 18 patients with 80 simple hepatic cysts had mild abdominal pain and 1 patient had alcohol reaction. After close observation, all of them were relieved by themselves without any other serious complications. Conclusion 1) through the analysis of the cases collected in this study, It was concluded that the curative rate of percutaneous injection of anhydrous alcohol in the treatment of simple hepatic cyst was 65% in 3 months, the total effective rate was 95 and the recurrence rate was 2.5, the cure rate in 6 months was 80, the total effective rate was 97.5, and the recurrence rate was 2.5. It was considered that this prescription was effective in treating simple hepatic cyst. Feasible. 2) safe, simple, simple and convenient. The operation method of sclerotherapy under the guidance of B-ultrasound in the treatment of simple hepatic cyst was performed under local anesthesia and dynamic observation of ultrasound. The operation process was accurate and intraoperative. The cost of this method is much lower than that of surgical treatment, and the patient's financial burden is low. The vast majority of patients can give a good combination of trauma small B ultrasound guide absolute alcohol sclerosis treatment of simple hepatic cyst is a minimally invasive operation, at the same time, the surgical wound is small, reducing the postoperative wound infection rate. It has been replaced by surgical traumatic surgery, which is more widely used in the population. 5) the patients can walk quickly on the second day after operation, without affecting the normal life of the patients.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575

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