Yang Chien-Fang, Liang Huei-Lung, Pan Huay-Ben, Lin Yih-Huie, Mok King-Tong, Lo Gin-Ho, Lai Kwok-Hung
Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan.
AJR Am J Roentgenol. 2006 Oct;187(4):940-3. doi: 10.2214/AJR.05.0621.
Our purpose was to evaluate the safety and therapeutic efficacy of single-session prolonged alcohol sclerotherapy in treating large hepatic cysts. A therapeutic comparison between 4-hour and 2-hour retention techniques was also studied.
Twenty-seven patients with 31 hepatic cysts were enrolled in this study. Seventeen patients (18 cysts) were treated by alcohol retention for 4 hours (group 1) and 10 patients (13 cysts) for 2 hours (group 2). The mean diameter of the hepatic cysts was 12.4 cm (range, 8-23 cm) with a comparable size range in each group. The sclerosing agent used was 95% alcohol, and the maximum amount was limited to 200 mL. Patients changed position and vital signs were monitored every 10-15 minutes. The blood alcohol concentrations were checked hourly for 5 consecutive hours in the initial nine patients. The nonparametric Mann-Whitney U test was used to compare the difference in characteristics and treatment results of the subjects between these two groups. The level of statistical significance was set at a p value of less than 0.05.
All but one patient in group 2 tolerated the entire course of sclerotherapy. The mean aspirated volume and mean injected alcohol volume of the hepatic cysts were 730 mL and 138.3 mL, respectively, in group 1 patients, and 931 mL and 139 mL, respectively, in group 2 patients. The mean maximum blood alcohol concentration was 128.2 mg/dL (range, 60-199 mg/dL) at 3-4 hours after alcohol instillation. The mean posttherapy residual cystic diameter was 2.5 cm (range, 0-6 cm), with an average volume reduction rate of 98.3% and 97.7%, respectively, for patients in group 1 and group 2 after a mean follow-up period of 29.6 months (9-59 months). No statistical differences of the mean reduction rate between the two groups were noted.
Long retention of the alcohol in a single-injection technique is safe and effective. Two-hour alcohol retention has a comparable efficacy to that of 4-hour retention.
我们的目的是评估单次长时间酒精硬化疗法治疗大型肝囊肿的安全性和治疗效果。同时还研究了4小时和2小时保留技术之间的治疗效果比较。
本研究纳入了27例患有31个肝囊肿的患者。17例患者（18个囊肿）接受了4小时的酒精保留治疗（第1组），10例患者（13个囊肿）接受了2小时的酒精保留治疗（第2组）。肝囊肿的平均直径为12.4厘米（范围8 - 23厘米），两组囊肿大小范围相当。使用的硬化剂为95%酒精，最大用量限制为200毫升。患者每10 - 15分钟更换一次体位，并监测生命体征。最初的9例患者连续5小时每小时检查一次血液酒精浓度。采用非参数曼 - 惠特尼U检验比较两组受试者的特征和治疗结果差异。统计学显著性水平设定为p值小于0.05。
第2组除1例患者外，其余患者均耐受了整个硬化治疗过程。第1组患者肝囊肿的平均抽出液量和平均注入酒精量分别为730毫升和138.3毫升，第2组患者分别为931毫升和139毫升。酒精注入后3 - 4小时的平均最大血液酒精浓度为128.2毫克/分升（范围60 - 199毫克/分升）。平均随访29.6个月（9 - 59个月）后，第1组和第2组患者治疗后囊肿残余平均直径为2.5厘米（范围0 - 6厘米），平均体积缩小率分别为98.3%和97.7%。两组之间平均缩小率无统计学差异。
单次注射技术中长时间保留酒精是安全有效的。2小时酒精保留与4小时保留的疗效相当。
