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【摘要】 目的：对比在超声引导下经皮肾囊肿穿刺硬化治疗两种方法的临床疗效。方法：将100例单纯性肾囊肿患者随机分为对照组与试验组各50例。对照组采用常规经皮肾囊肿穿刺硬化治疗，即超声引导下肾囊肿单次穿刺注射无水乙醇治疗；试验组实施置管多次硬化治疗，采用超声引导下肾囊肿穿刺注射无水乙醇后置入猪尾巴导管持续引流、多次注入无水乙醇治疗。结果：于随访2年进行超声复查，两组患者治肾囊肿均明显缩小或消失。两组患者治疗后治愈率及复发率比较差异均有统计学意义（P<0.05）。结论：置管多次硬化治疗较常规硬化治疗肾囊肿，复发率更低，效果更显著。
【关键词】 超声介入治疗； 持续引流； 单纯性肾囊肿
Two Methods of Curative Effect Comparison of Ultrasound Guided Percutaneous Renal Cyst Puncture Sclerotherapy/QIAN Ying，QIAN Jian-lin， CHEN Chu-hong.//Medical Innovation of China，2016，13（06）：025-028
【Abstract】 Objective：To investigate the clinical efficacy of two different sclerotherapy of pure renal cysts by absolute alcohol injection by ultrasound guided. Method： 100 patients with pure renal cyst were randomly divided into control group （n=50） and experimental group （n=50）.The control group used absolute alcohol injection for sclerotherapy of pure renal cysts by ultrasound guided，only one time， the experimental group used constant drainaged with pigtail tube by ultrasound guided and treated by sclerotherapy with absolute alcohol injection，three times or more. The adverse effects and effective rates of the two groups were observed and compared. Result：All patients were followed up for 24 months or more， two groups of patients with renal cyst were significantly shrink or disappear. After treatment， the cure rate and recurrence rate were compared between the two groups，the differences were statistically significant （P<0.05）. Conclusion：Constant drainaged with pigtail tube by ultrasound guided and treated by sclerotherapy with absolute alcohol injection are very effective and safe in the treatment of pure renal cyst.
【Key words】 Ultrasound interventional treatment； Continuous drainage； Pure renal cysts
First-author’s address：Shanghai Jiangong Hospital ， Shanghai 200083，China
doi：10.3969/j.issn.1674-4985.2016.06.008
肾囊肿是常见的肾脏良性疾病之一，50岁以上中老年人的发病率约占27%，且随着年龄的增长其数目和大小有增加趋势[1-2]。肾囊肿常用的治疗方法主要有腹腔镜肾囊肿去顶减压术、经皮肾囊肿穿刺硬化治疗、开放性肾囊肿去顶减压术等，目前临床多采用前两种方法。超声引导下经皮肾囊肿穿刺注射硬化治疗，已被国内外广泛应用，它不仅可以清晰显示肾囊肿的位置、大小和深度以及与周围脏器的关系，还能实时监测肾囊肿穿刺治疗的整个过程，操作简单，方便易行，安全性高，且费用较低[3]。尽管该治疗方法是目前治疗单纯肾囊肿的主要方法，但其仍存在一定的复发率，约10%左右。
2012年7月-2013年6月，笔者应用置管多次硬化治疗，即超声引导下经皮肾囊肿穿刺置管引流多次注射无水乙醇硬化治疗单纯性肾囊肿50例，随访2年，并与常规硬化（即传统的超声引导下经皮肾囊肿单次穿刺引流注射无水乙醇）治疗的50例患者进行比较，取得良好效果，现报道如下。
1 资料与方法
1.1 一般资料 选取单纯性肾囊肿患者100例，所有病例均符合肾囊肿的入选标准及排除标准。入选标准：肾囊肿（上中下极）直径≥4 cm，单发。同时超声检查测量囊肿的3个径线，并计算出囊肿的体积（0.52×前后径×左右径×上下径）。排除标准：排除肾盂旁囊肿、出血性疾病；肾积水；复发性肾囊肿穿刺史；肾脏手术史。100例患者术前均经腹部超声、CT检查等确诊。入院前的症状包括：腰部胀痛78例，镜下血尿27例。将患者随机分成两组：超声引导下经皮肾囊肿单次穿刺囊内注射95%无水乙醇组（对照组）和超声引导下经皮肾囊肿穿刺囊内置管引流多次注射95%无水乙醇组（试验组），每组各50例。对照组年龄29～86岁，肾囊肿体积32.32～593.25 mL；试验组年龄36～82岁，肾囊肿体积45.25～672.67 mL，两组患者在性别、年龄及肾囊肿大小等方面比较差异均无统计学意义（P>0.05），见表1。
【关键词】 超声介入治疗； 持续引流； 单纯性肾囊肿
Two Methods of Curative Effect Comparison of Ultrasound Guided Percutaneous Renal Cyst Puncture Sclerotherapy/QIAN Ying，QIAN Jian-lin， CHEN Chu-hong.//Medical Innovation of China，2016，13（06）：025-028
【Abstract】 Objective：To investigate the clinical efficacy of two different sclerotherapy of pure renal cysts by absolute alcohol injection by ultrasound guided. Method： 100 patients with pure renal cyst were randomly divided into control group （n=50） and experimental group （n=50）.The control group used absolute alcohol injection for sclerotherapy of pure renal cysts by ultrasound guided，only one time， the experimental group used constant drainaged with pigtail tube by ultrasound guided and treated by sclerotherapy with absolute alcohol injection，three times or more. The adverse effects and effective rates of the two groups were observed and compared. Result：All patients were followed up for 24 months or more， two groups of patients with renal cyst were significantly shrink or disappear. After treatment， the cure rate and recurrence rate were compared between the two groups，the differences were statistically significant （P<0.05）. Conclusion：Constant drainaged with pigtail tube by ultrasound guided and treated by sclerotherapy with absolute alcohol injection are very effective and safe in the treatment of pure renal cyst.
【Key words】 Ultrasound interventional treatment； Continuous drainage； Pure renal cysts
First-author’s address：Shanghai Jiangong Hospital ， Shanghai 200083，China
doi：10.3969/j.issn.1674-4985.2016.06.008
肾囊肿是常见的肾脏良性疾病之一，50岁以上中老年人的发病率约占27%，且随着年龄的增长其数目和大小有增加趋势[1-2]。肾囊肿常用的治疗方法主要有腹腔镜肾囊肿去顶减压术、经皮肾囊肿穿刺硬化治疗、开放性肾囊肿去顶减压术等，目前临床多采用前两种方法。超声引导下经皮肾囊肿穿刺注射硬化治疗，已被国内外广泛应用，它不仅可以清晰显示肾囊肿的位置、大小和深度以及与周围脏器的关系，还能实时监测肾囊肿穿刺治疗的整个过程，操作简单，方便易行，安全性高，且费用较低[3]。尽管该治疗方法是目前治疗单纯肾囊肿的主要方法，但其仍存在一定的复发率，约10%左右。
2012年7月-2013年6月，笔者应用置管多次硬化治疗，即超声引导下经皮肾囊肿穿刺置管引流多次注射无水乙醇硬化治疗单纯性肾囊肿50例，随访2年，并与常规硬化（即传统的超声引导下经皮肾囊肿单次穿刺引流注射无水乙醇）治疗的50例患者进行比较，取得良好效果，现报道如下。
1 资料与方法
1.1 一般资料 选取单纯性肾囊肿患者100例，所有病例均符合肾囊肿的入选标准及排除标准。入选标准：肾囊肿（上中下极）直径≥4 cm，单发。同时超声检查测量囊肿的3个径线，并计算出囊肿的体积（0.52×前后径×左右径×上下径）。排除标准：排除肾盂旁囊肿、出血性疾病；肾积水；复发性肾囊肿穿刺史；肾脏手术史。100例患者术前均经腹部超声、CT检查等确诊。入院前的症状包括：腰部胀痛78例，镜下血尿27例。将患者随机分成两组：超声引导下经皮肾囊肿单次穿刺囊内注射95%无水乙醇组（对照组）和超声引导下经皮肾囊肿穿刺囊内置管引流多次注射95%无水乙醇组（试验组），每组各50例。对照组年龄29～86岁，肾囊肿体积32.32～593.25 mL；试验组年龄36～82岁，肾囊肿体积45.25～672.67 mL，两组患者在性别、年龄及肾囊肿大小等方面比较差异均无统计学意义（P>0.05），见表1。