摘要
目的探讨肝、肾囊肿介入性治疗所发生的并发症及失误17例的原因及防治方法．方法回顾性分析笔者近3a所施行的肝、肾囊肿介入性治疗118例（均以无水乙醇为治疗药物）。其中出现并发症及失误共17例，1例（肝囊肿）发生休克，4例（肝囊肿）术后出现酒精不耐受及过敏表现；2例（1例肝囊肿。1例肾囊肿）部分无水乙醇渗漏至腹腔内；1例（肾囊肿）部分无水乙醇进入肾盂；3例（1例肝囊肿。2例肾囊肿）注入无水乙醇后无法抽出；1例（肝囊肿）穿通肋膈角；1例（肾囊肿）误穿至胆囊；1例（肝囊肿）出现肝包膜下血肿；1例（肾囊肿）出现肾包膜下血肿；2例（1例肝囊肿，1例肾囊肿）抽出囊液后因针尖脱出囊腔而终止手术．结果1例发生休克者，给予抗休克治疗后改善；4例酒精不耐受过敏者，给予对症静点药物治疗后好缔；2例部分酒精渗漏者经对症处理后缓解；1例酒精进入肾盂者，即可输液、利尿，2d后病情改善；3例囊肿内酒精存留者，经注水稀释。病人无明显不适；1例穿通肋脯角者，给予对症抗炎治疗后痊愈；1例误穿至胆囊者，将胆汁全部抽出，未出现其他临床症状；1例出现肝包下血肿及1例肾包膜下血肿病人，经观察血肿未再增大，未做特殊处理；2例针尖脱出囊腔者．3个月后囊肿复发，再次行介入治疗并获成功．结论介入治疗肝、肾囊肿是普遍采用的方法，但因各种因素可发生少数并发症及失误，且随着客观条件的改善及技术操作经验的不断积累，并成症及失误会大大降低．
Objective To explore the causes, prevention and treatment of the complications and faults in intervention therapy for hepatic and renal cysts in 17 cases. Methods In recent 3 years, 118 cases of hepatic and renal cysts were treated by intervention therapy （absolute ethyl alcohol as therapeutic medicine in all cases）, and 17 cases of complications and faults were found by retrospective analysis; shock occurred in 1 case （hepatic cyst）; intolerance to alcohol with allergy in 4 cases（hepatic cysts）; leaking of some alcohol to peritoneal cavity in 2 cases（1 case of hepatic cyst and 1 case of renal cyst）; some alcohol entered the renal pelvis in lcase （renal cyst）; no way to suck out the injected alcohol in 3 cases（1 case of hepatic cyst and 2 cases of renal cysts） ; penetration costophrrenic angle in 1 case（hepatic cyst） ; faulty penetration to gallbladder in 1 case（renal cyst）; hematoma occurred under hepatic capsule in 1 case（hepatic cyst）; hematoma occurred under renal capsule in 1 case（renal cyst） ; termination of the operation due to falling off the needle from the cyst cavity after sucking out the fluid in the cyst in 2 cases（1 case of hepatic cyst and 1 case of renal cyst）. Results In 1 case of shock the condition is improved after anti-shock therapy. In 4 cases of intolerance to alcohol with allergy, the condition is improved after intravenous symptoraatic therapy. In 2 cases of partial alcohol leakage, the condition was relieved by symptomatic treatment. In 1 case of alcohol entering the renal pelvis, symptoms is improved 2 days later due to immediate fluid infusion and diuretic therapy. In 3 cases of alcohol retention in the cysts, no apparent symptom occurred after dilution with water injection. In 1 case of penetration via costodiaphragmatic angle, the patient was cured after symptomatic anti-inflammatory therapy. In 1 case of faulty penetration to gallbladder＇, no clinical symptoms appeared after complete sucking out the bile. In 1 case of hematoma under hepatic capsule and 1 case of hematoma under renal capsule, no special treatment was treated because of no further enlargement of the mass. In 2 cases of falling off the needle from the cyst cavity. The cysts relapsed 3 months later, and further intervention therapy succeeded after treatment. Conclusion Intervention therapy, for hepatic and renal cysts is a generally applied method. Few complications and faults may occur due to different factors, and accompanying the improvement of objective conditions and continuous accumulation of experiences in technical operation, the complications and faults will decrease considerably after treatment.
出处
《北华大学学报（自然科学版）》
CAS
2006年第6期522-524,共3页
Journal of Beihua University（Natural Science）
关键词
肝囊肿
肾囊肿
介入性
抽吸硬化术
Hepatic cyst
Renal cyst
Intervention
Suction sclerotherapy
