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目的比较超声引导下无水乙醇硬化治疗直径6～9 cm单纯性肝囊肿(SHC)中反复冲洗法、保留乙醇法、置管引流法3种方法之间的效果差异。方法选择直径6～9 cm的SHC患者126例,分为3组:A组、B组、C组各42例,分别行超声引导下无水乙醇硬化反复冲洗法、保留乙醇法、置管引流法治疗。A、B组患者观察2～3 h,C组患者住院观察至拔除引流管后2～3 h;所有患者均随访6个月,6个月后超声复查判断疗效。结果所有患者均完成随访,无失访病例。A组治愈、有效、无效分别为27例、13例、2例;B组治愈、有效、无效分别为14例、17例、11例;C组治愈、有效、无效分别为29例、12例、1例。3组间疗效比较,差异有统计学意义(Zc=16.829,P<0.05);组间两两比较,A组与C组的疗效明显高于B组(P<0.01),而A组与C组间疗效差异无统计学意义(P>0.05)。C组医疗费用明显高于A组与B组(P<0.01)。所有患者未出现严重并发症;不良反应主要为醉酒样反应(面色潮红、恶心呕吐、头昏)、右上腹局部胀痛不适,1～2 h后自行消失;B组出现针尖滑出囊腔2例、囊内少许出血2例,C组出现肝脏极少量出血2例、引流管脱落1例。结论对于直径6～9 cm的SHC,反复冲洗法比保留乙醇法及置管引流法具有优势,不仅疗效好、不良反应少,而且方便、费用低,更易被患者接受。
Objective To compare the effects of ultrasound-guided absolute ethanol sclerotherapy on repeated flushing in 6 ~ 9 cm diameter hepatic cysts (SHC), preserving ethanol and catheter drainage. Methods A total of 126 SHC patients with a diameter of 6 ~ 9 cm were divided into 3 groups: group A, group B and group C, 42 cases each. The patients were treated with ultrasonic repeatedly ethanol scrubbing, Law treatment. The patients in group A and group B were observed for 2 ~ 3 h. The patients in group C were hospitalized for 2 ~ 3 h after drainage tube drainage. All patients were followed up for 6 months and 6 months later to determine the therapeutic effect. Results All patients were followed up, no case of follow-up. A group of cured, effective and ineffective were 27 cases, 13 cases, 2 cases; B group cured, effective and ineffective were 14 cases, 17 cases, 11 cases; C group cured, effective, ineffective were 29 cases, 12 cases , 1 case. The curative effect between the three groups was statistically significant (Zc = 16.829, P <0.05). The curative effect of group A and group C was significantly higher than that of group B (P <0.01) There was no significant difference in efficacy between groups (P> 0.05). The cost of medical care in group C was significantly higher than that in group A and B (P <0.01). All patients did not appear serious complications; adverse reactions were mainly drunk-like reaction (flushing, nausea and vomiting, dizziness), the right upper quadrant painful discomfort, disappeared after 1 ~ 2 h; B group appeared needle tip out of the cyst 2 For example, 2 cases of intracapsular hemorrhage, 2 cases of minimal bleeding in group C, and 1 case of drainage tube shedding. Conclusions For SHC with diameter of 6 ~ 9 cm, repeated irrigation method has the advantages of preserving ethanol method and catheter drainage method. It not only has good curative effect and less adverse reactions, but also is convenient, inexpensive and easy to be accepted by patients.