Salama H, Farid Abdel-Wahab M, Strickland G T
Department of Tropical Medicine, Cairo University, Egypt.
Clin Infect Dis. 1995 Dec;21(6):1372-6. doi: 10.1093/clinids/21.6.1372.
The usefulness of echo-guided percutaneous cyst puncture in the diagnosis and treatment of hepatic hydatid cysts was assessed in a study of 45 patients referred to the Department of Tropical Medicine at Kasr El Aini Hospital in Cairo. All subjects had at least one hepatic cyst detected by ultrasonography (54 cysts in all), and 42 patients had positive results in serological tests for antibodies to Echinococcus granulosus. The majority of cysts were in the right hepatic lobe (40 cysts), were anechoic (51), and were rounded and smooth (49). All 45 active cysts (44 anechoic, rounded, and smooth; one anechoic and septated) yielded clear watery fluid containing scolices and exhibited elevated pressure on percutaneous puncture. In contrast, all nine inactive cysts yielded cloudy yellowish fluid without detectable scolices and did not display elevated pressure on puncture. The latter cysts were anechoic and elliptical (two cysts); anechoic and septated (one); anechoic with a calcified wall (one) or a detached germinal layer (two); or rounded with coarse echoes (three). Treatment by injection of a scolicidal agent (hypertonic saline) before withdrawal of the needle used for aspiration gave excellent results and was not associated with complications. Forty-three of the 45 patients had no clinical or ultrasonographic evidence of recurrent or new hepatic cysts after 3 years of follow-up.
在一项针对开罗艾因·卡西尔医院热带医学科收治的45例患者的研究中，评估了超声引导下经皮肝囊肿穿刺术在肝包虫囊肿诊断和治疗中的作用。所有受试者经超声检查至少发现一个肝囊肿（共54个囊肿），42例患者棘球绦虫抗体血清学检测呈阳性。大多数囊肿位于肝右叶（40个囊肿），为无回声（51个），呈圆形且边界光滑（49个）。45个活动性囊肿（44个无回声、圆形且边界光滑；1个无回声且有分隔）经皮穿刺均抽出含有头节的清亮水样液体，且穿刺时压力升高。相比之下，9个非活动性囊肿抽出的是浑浊淡黄色液体，未检测到头节，穿刺时压力未升高。后者的囊肿为无回声且呈椭圆形（2个囊肿）；无回声且有分隔（1个）；无回声且有钙化壁（1个）或生发层分离（2个）；或圆形且回声粗糙（3个）。在抽出用于抽吸的针之前注射杀头节剂（高渗盐水）进行治疗效果极佳，且未出现并发症。45例患者中有43例在随访3年后无临床或超声证据表明有复发性或新发肝囊肿。
