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有症状的非寄生虫性良性肝囊肿的经皮治疗:单次酒精硬化疗法与负压延长导管引流术的比较

Percutaneous treatment of symptomatic non-parasitic benign liver cysts: single-session alcohol sclerotherapy versus prolonged catheter drainage with negative pressure.

作者信息

Zerem Enver, Imamović Goran, Omerović Safet

机构信息

University Medical Center, 75 000 Tuzla, Bosnia and Herzegovina.

出版信息

Eur Radiol. 2008 Feb;18(2):400-6. doi: 10.1007/s00330-007-0760-5. Epub 2007 Sep 25.

Abstract

To evaluate whether prolonged catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the treatment of symptomatic non-parasitic benign liver cysts. Forty patients were randomly assigned to two groups in a 24-month prospective controlled trial. One group was treated with ultrasound-guided prolonged catheter drainage with negative pressure (20 patients with 24 cysts) and the other group with single-session alcohol sclerotherapy (20 patients with 23 cysts). Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed. The median volumes and 95% CI (confidence interval) for the medians and interquartile ranges of all 47 cysts before treatment and on last follow-up were: 389 ml, 143-1,127 ml, 136-1,300 ml, and 0 ml, 0-10 ml, and 0-23 ml, respectively (P<0.0001). The average volume reduction was 92.4% (range, 74.9-100%), 94.2 % (range, 74.9-100%) in the drainage and 90.2% (range, 76.9-100%) in the sclerotherapy group. Twenty-seven cysts (57.4%) disappeared completely, 16 (66.7%) in the drainage and 11 (47.8%) in the sclerotherapy group. No differences in average volume reduction, final volume and disappearance of the cysts between the groups were noted. The hospital stay was 1 day for all patients. Percutaneous treatment is safe and effective for hepatic non-parasitic cysts. Prolonged catheter drainage with negative pressure and single-session alcohol sclerotherapy had similar results.

摘要

为评估在有症状的非寄生虫性良性肝囊肿治疗中,负压延长导管引流术是否比单次酒精硬化疗法效果更佳。在一项为期24个月的前瞻性对照试验中,40例患者被随机分为两组。一组接受超声引导下的负压延长导管引流术(20例患者,24个囊肿),另一组接受单次酒精硬化疗法(20例患者,23个囊肿)。对患者的人口统计学特征、临床特点、治疗结果及并发症进行分析。治疗前及末次随访时,所有47个囊肿的中位数体积及中位数的95%置信区间(CI)和四分位数间距分别为:389 ml,143 - 1127 ml,136 - 1300 ml,以及0 ml,0 - 10 ml,0 - 23 ml(P<0.0001)。引流组平均体积缩小率为92.4%(范围74.9% - 100%),硬化疗法组为94.2%(范围74.9% - 100%),硬化疗法组为90.2%(范围76.9% - 100%)。27个囊肿(57.4%)完全消失,引流组16个(66.7%),硬化疗法组11个(47.8%)。两组间囊肿平均体积缩小、最终体积及消失情况无差异。所有患者住院时间均为1天。经皮治疗肝非寄生虫性囊肿安全有效。负压延长导管引流术和单次酒精硬化疗法效果相似。

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