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目的探究超声内镜引导下无水乙醇灌洗术(EUS-EL)治疗胰腺浆液性囊性肿瘤的临床疗效及安全性。方法回顾性分析第二军医大学长海医院消化内科2012年5月至2014年11月期间收治的13例胰腺浆液性囊性肿瘤患者的临床资料,其中6例接受超声内镜引导下无水乙醇灌洗术治疗及术后随访,另7例仅接受超声内镜引导下囊液抽吸术,进行为期7~36个月的随访。对两组患者临床症状、病灶大小的变化及复发率进行了比较,统计手术相关并发症的情况。结果 EUS-EL治疗组在治疗前后囊肿最大直径分别为(24.8±14.2)mm及(9.0±4.8)mm(P=0.004)。对照组在治疗前后囊肿最大直径分别为(21.3±11.6)mm及(18.6±14.0)mm(P=0.203)。EUS-EL治疗组和对照组的囊肿最大直径的变化分别为-15.8±3.1mm和-2.7±1.9mm(P=0.003)。EUS-EL治疗组无相关并发症发生,也无复发病例。治疗组囊肿完全消除4例,对照组完全消除1例。治疗组5例患者腹痛症状缓解,腹痛缓解1例(P=0.11)。结论接受EUS-EL治疗胰腺浆液性囊性肿瘤可有效缓解临床症状、减小病灶大小,并发症少,安全性较高。
Objective To investigate the clinical efficacy and safety of endoscopic ultrasonography (EUS-EL) in the treatment of pancreatic serous cystadenocarcinoma. Methods The clinical data of 13 patients with pancreatic serous cystadenoma admitted to Department of Gastroenterology, Changhai Hospital, Second Military Medical University from May 2012 to November 2014 were retrospectively analyzed. Among them, 6 patients underwent ultrasound-guided endoscopic perfusion of ethanol Scrub treatment and postoperative follow-up, and the other 7 cases were only under endoscopic ultrasonography guided cyst fluid suction, for a period of 7 to 36 months of follow-up. The clinical symptoms, the size of lesions and the recurrence rate of the two groups were compared, and the complications related to surgery were analyzed. Results The maximum diameters of cysts in EUS-EL group before and after treatment were (24.8 ± 14.2) mm and (9.0 ± 4.8) mm respectively (P = 0.004). The maximum diameters of the cysts in the control group before and after treatment were (21.3 ± 11.6) mm and (18.6 ± 14.0) mm respectively (P = 0.203). The maximum diameter of cysts in the EUS-EL treatment group and the control group were -15.8 ± 3.1 mm and -2.7 ± 1.9 mm, respectively (P = 0.003). EUS-EL treatment-related complications without recurrence. In the treatment group, 4 cases were completely eliminated and 1 case was completely eliminated in the control group. In the treatment group, the symptoms of abdominal pain were relieved in 5 cases and relieved in 1 case (P = 0.11). Conclusion EUS-EL treatment of pancreatic serous cystic tumors can effectively relieve clinical symptoms, reduce the size of the lesion, fewer complications and higher safety.