B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿.doc

B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿[摘要] 目的：探讨经皮穿刺置管无水乙醇灌洗治疗肾囊肿的效果及安全性。方法：经B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿，术后3、6、12个月随访，观察囊肿大小变化及不良反应发生情况，以确定其疗效与安全性。结果：138例肾囊肿经B超引导下穿刺留置导管无水乙醇灌洗后3、6、12个月随访，治愈率为89.13%、94.20%、98.55%，有效率为100%。结论：B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿，方法简单，疗效确切，设备要求低，适于在基层医院推广应用，是肾囊肿有效治疗方法之一。 [关键词] B型超声；留置导管；肾囊肿；无水乙醇；穿刺术 [中图分类号] R692 [文献标识码] B [文章编号] 1674-4721（2011）02（b）-076-02 Ethanol lavage treatment of renal cysts through B ultrasonic-guided catheter indwelling centesis LIU Peiming (Department of Surgical, The People’s Hospital of Fanxian, Henan Province, Fanxian 457500, China) [Abstract] Objective: To discuss the efficacy and safety of ethanol lavage treatment of renal cysts via indwelling catheter punctured through skin. Methods: Treat renal cysts through B ultrasonic-guided catheter centesis ethanol lavage. Followed-up after 3, 6 and 12 months of operation. Observed changes in cyst size and the incidence of adverse reactions to determine its efficacy and safety. Results: Followed-up the 138 renal cysts cases given the B-scan guided catheter centesis ethanol lavage treatment after 3, 6, and 12 months of operation, the cure rate was respectively 89.13％, 94.20％, and 98.55％. Conclusion: Treatment of renal cysts using B ultrasonic-guided catheter centesis ethanol lavage method, with the advantage of simple, effective, low requirement of equipment and easy application in primary hospitals, will be an effective way of treating renal cysts. [Key words] Bmode ultrasonic; Catheter indwelling; Renal cysts; Ethanol; Centesis 肾囊肿是肾脏常见的良性病变，随着介入技术的发展，超声引导下经皮肾囊肿穿刺注入硬化剂治疗，因疗效确切、简单易行、费用低廉已作为治疗首选。本院2005年6月～2009年11月共收治138例肾囊肿患者，采用经B超引导下穿刺留置导管无水乙醇灌洗治疗，经术后3～12个月随访，对单纯性肾囊肿疗效确切。现报道如下： 1 资料与方法 1.1 一般资料 本组138例患者，男90例，女48例，年龄34～83岁，平均63岁。右肾78例，左肾60例。囊肿直径为4.2～9.3 cm。抽出囊液35～180 ml。患者均行B超、IVP、CT检查确诊，排除肿瘤，并证实囊肿与肾集合系统不相通。 1.2 治疗方法 术前均证实为单纯性肾囊肿，行血常规、尿常规、出凝血时间、心电图检查，无绝对手术禁忌。据囊肿所在肾脏位置采用俯卧或侧卧位。B超定位要求：①避开重要脏器或大血管；②力求穿刺距离最短[1]。在B超引导下用中心静脉导管穿刺至囊肿中心，拔除针芯，见有囊液流出，置入导丝，退出针鞘，沿导丝置入皮肤扩张器，扩张后