裴少华 郑剑 黄晶 何可雄

摘要：目的：觀察比较不同超声下肾囊肿穿刺硬化术治疗肾囊肿的临床疗效。方法：选取我院于2017年11月至2019年2月收治的42例单纯性肾囊肿患者作为研究对象，依据随机数字表法将其分为单次组和多次组，各21例;单次组患者采用常规经皮肾囊肿穿刺硬化单次穿刺治疗，多次组则采取超声下经皮肾囊肿置入猪尾巴导管持续多次治疗;比较两组患者手术疗效、治疗情况、生活质量、疼痛程度、囊肿复发率及囊肿变化情况。结果：术后6个月，单次组手术总有效率80.95%明显低于多次组100%（P<0.05）;两组患者住院天数、手术时间、治疗费用及术后2h、1d、2d视觉模拟评分法（VAS）得分比较，无明显统计学意义（P>0.05）;与术前相比，术后1年两组患者QLQ-C30各评分均显著上升，多次组患者较单次组上升更为明显（P<0.05）;术后1年，两组患者囊肿复发率比较差异无统计学意义（χ2=0.276，P=0.600）;多次组囊肿缩小一半时间和完全消失时间均显著短于单次组（P<0.05）。结论：超声下经皮肾囊肿置入猪尾巴导管持续多次治疗在肾囊肿患者的应用中疗效更为明显，对提高患者生活质量也具有显著意义。

关键词：超声介入治疗;肾囊肿穿刺硬化术;肾囊肿

中图分类号：R445文献标识码：BDOI：10？郾3969/j.issn.1001-0270.2021.03.05

Abstract： Objective： To observe the clinical effects of different ultrasound-guided renal cyst puncture sclerotherapy in the treatment of renal cyst. Methods：Totally 42 patients with simple renal cysts admitted to the hospital from November 2017 to February 2019 were selected as study subjects. According to random number table method， they were divided into single group and multiple groupwith 21 cases in each group. Patients in the single group were treated by conventional percutaneous renal cyst puncture sclerotherapy with single puncture， while patients in the multiple groupwere treated by continuous and multiple ultrasound-guided percutaneous treatments with implantation of pigtail catheters. Surgical results， treatment， quality of life， pain degree， cyst recurrence rate and changes in cystswere compared between the two groups. Results： 6 months after the operation， the total effective rate in the single group was 80.95%， significantly lower than 100% in the multiple group （P<0.05）. There were no statistically significant differences between the two groups in terms of the length of hospital stay， operation time， treatment cost， andvisual analogue scale（VAS） scoresat 2h， 1d and 2d after the operation （P>0.05）. Compared with pre-operation， the QLQ-C30 scores of the two groups were increased at 1 year after the operation， and the increases of multiple group were more obvious （P<0.05）. In 1 year after the operation， there was no significant difference in cystrecurrence rate between the two groups （χ2=0.276， P=0.600）. The time for cysts decreasing by half and complete disappearance timein the multiple group were significantly shorter than those in the single group （P<0.05）. Conclusion： Continuous and multiple ultrasound-guided percutaneous treatments with implantation of pigtail catheters is more effective in the treatment of patients with renal cyst， which is highly significant for improving the patientsquality of life.

Key Words： Ultrasound-guided interventional treatment; Renal cyst puncture sclerotherapy; Renal cyst

肾囊肿是成年人肾脏最为常见的一种结构异常，其中单纯性的肾囊肿较为多见，一般无临床症状，不影响肾功能，但可见腹痛、腹部包块及高血压等，多为单侧单发，且好发于50岁以上的成年人。病因主要分为两大类，一是原发性淋巴水肿，由淋巴管发育异常导致;二是继发性淋巴水肿，常因某些疾病造成淋巴管阻塞[1-2]。目前，治疗该病的方法较多，据报道尚无可治疗肾囊肿的药物，开放手术行肾囊肿去顶术治疗效果好，治愈率可达100%，但创口较大，易诱发并发症，术后康复时间较长[3]。随着各类先进器械不断应用于临床，传统开放手术基本已被各种微创治疗手段所取代。超声引导下经皮肾囊肿穿刺硬化疗法在国内外被广泛应用，不仅能清晰显示囊肿的位置、大小及周围脏器，还可以对囊肿手术全过程进行实时监测，具有高效、安全、易于执行等优点[4-5]。……