本文選題：單純性肝囊腫 + 無(wú)水酒精　； 參考：《石河子大學(xué)》2014年碩士論文

【摘要】：目的：探討B(tài)超引導(dǎo)下經(jīng)皮肝穿刺注射無(wú)水酒精硬化治療單純性肝囊腫的方法，評(píng)價(jià)該治療方法的臨床療效及臨床應(yīng)用價(jià)值，最大努力確保B超引導(dǎo)下經(jīng)皮肝穿刺注射無(wú)水酒精硬化治療單純性肝囊腫的有效性、安全性，為進(jìn)一步提高通過(guò)此方法治療單純性肝囊腫的療效、降低術(shù)中、術(shù)后并發(fā)癥的發(fā)生率，總結(jié)臨床經(jīng)驗(yàn)，從而更好地在臨床工作中展開推廣。 方法：收集石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院2008年1月-2013年6月單純性肝囊腫患者病例80例，所有病例均采用超聲引導(dǎo)下經(jīng)皮肝穿刺注射無(wú)水酒精硬化治療，且均為第1次治療。治療結(jié)束后隨訪觀察治療情況，隨訪時(shí)間為3-6個(gè)月，復(fù)查腹部B超，以4級(jí)療效指數(shù)辦法對(duì)療效進(jìn)行判斷，以術(shù)中、術(shù)后是否出現(xiàn)腹痛、酒精反應(yīng)、出血、感染作為療法安全性觀察指標(biāo)，對(duì)治療要點(diǎn)和術(shù)中并發(fā)癥發(fā)生情況進(jìn)行分析，通過(guò)隨訪觀察，評(píng)價(jià)療效及分析治療情況。 結(jié)果：收集80例單純性肝囊腫患者均成功穿刺，抽出囊液為無(wú)色或黃色清亮。80例單純性肝囊腫患者中穿刺治療1次77例，2次2例，3次1例，其中行3次無(wú)水酒精硬化治療者囊腫直徑為12.1cm×10.3cm，治療過(guò)程順利，穿刺間隔時(shí)間為1周，治療過(guò)程中及結(jié)束后觀察患者無(wú)明顯不適癥狀。80例單純性肝囊腫患者治療術(shù)后總有效率：隨訪3個(gè)月95%，隨訪6個(gè)月97.5%。治療術(shù)后治愈率：隨訪3個(gè)月65%，隨訪6個(gè)月80%。共2例患者復(fù)發(fā)，，復(fù)發(fā)率為2.5%，治療效果顯著。手術(shù)操作過(guò)程順利，與患者詳細(xì)溝通后80例患者均配合良好，術(shù)中未出現(xiàn)一例嚴(yán)重并發(fā)癥，治療80例單純性肝囊腫患者共有18例出現(xiàn)輕度腹痛，1例患者出現(xiàn)酒精反應(yīng)，經(jīng)密切觀察后均自行緩解，未出現(xiàn)其他嚴(yán)重并發(fā)癥。 結(jié)論：（1）有效通過(guò)對(duì)本課題研究所收集的病例進(jìn)行分析，總結(jié)出經(jīng)皮肝穿刺注射無(wú)水酒精治療單純性肝囊腫3個(gè)月治愈率為65%，總有效率為95%，復(fù)發(fā)率為2.5%；6個(gè)月的治愈率為80%，總有效率為97.5%，復(fù)發(fā)率為2.5%，認(rèn)為此方治療單純性肝囊腫有效、可行。（2）安全、簡(jiǎn)便本課題所研究的B超引導(dǎo)下硬化治療單純性肝囊腫的手術(shù)方式在局部麻醉及超聲動(dòng)態(tài)觀察下進(jìn)行治療，操作過(guò)程精確，術(shù)中、術(shù)后未出現(xiàn)一例嚴(yán)重并發(fā)癥。（3）費(fèi)用低此治療方法手術(shù)費(fèi)用遠(yuǎn)低于外科手術(shù)治療，患者經(jīng)濟(jì)負(fù)擔(dān)小，絕大多數(shù)患者能予以很好的配合（4）創(chuàng)傷小B超引導(dǎo)下無(wú)水酒精硬化治療單純性肝囊腫是一種微創(chuàng)手術(shù)，同時(shí)其手術(shù)傷口小，降低了術(shù)后傷口感染率，已取代了外科創(chuàng)傷性手術(shù)治療，其適用人群更為廣泛。（5）恢復(fù)快患者在術(shù)后第二天即可下地行走，不影響患者正常生活。
[Abstract]:Objective: to evaluate the clinical efficacy and clinical value of percutaneous ethanol sclerosis under B-ultrasound guidance in the treatment of simple hepatic cysts. The best efforts were made to ensure the efficacy and safety of percutaneous ethanol injection under the guidance of B-ultrasound in the treatment of simple hepatic cysts. In order to further improve the efficacy of this method in the treatment of simple hepatic cysts, and reduce the intraoperative efficacy, The incidence of postoperative complications, summarized clinical experience, so as to better spread in the clinical work. Methods: 80 patients with simple hepatic cyst were collected from the first affiliated Hospital of Shihezi University Medical College from January 2008 to June 2013. All the patients were treated with percutaneous injection of anhydrous alcohol sclerosis under the guidance of ultrasound for the first time. The treatment was followed up for 3-6 months after the treatment. Abdominal B-ultrasound was re-examined and the curative effect was judged by the method of 4-grade curative effect index. Whether abdominal pain, alcohol reaction, bleeding occurred during or after the operation, or not, was determined by the method of grade 4 curative effect index. Infection was used as a safety observation index to analyze the main points of treatment and the occurrence of intraoperative complications. Through follow-up observation, the curative effect and treatment were evaluated and analyzed. Results: 80 cases of simple hepatic cyst were successfully punctured. The extraction fluid was colorless or yellow clear. In 80 cases of simple hepatic cyst, 77 cases were treated once, 2 cases were treated twice, 2 cases were 3 times, 1 case. The diameter of cysts was 12.1cm 脳 10. 3 cm after 3 times of anhydrous alcohol sclerotherapy. The procedure was smooth, and the interval between puncture and puncture was 1 week. The total effective rate of 80 patients with simple hepatic cyst after treatment was 95% for 3 months and 97. 5 for 6 months. The cure rate was 65% for 3 months and 80% for 6 months. There were 2 cases of recurrence, the recurrence rate was 2.5%, and the therapeutic effect was remarkable. The operation was smooth, 80 patients had good cooperation after detailed communication with the patients, no serious complications occurred during the operation, 18 patients with 80 simple hepatic cysts had mild abdominal pain and 1 patient had alcohol reaction. After close observation, all of them were relieved by themselves without any other serious complications. Conclusion 1) through the analysis of the cases collected in this study, It was concluded that the curative rate of percutaneous injection of anhydrous alcohol in the treatment of simple hepatic cyst was 65% in 3 months, the total effective rate was 95 and the recurrence rate was 2.5, the cure rate in 6 months was 80, the total effective rate was 97.5, and the recurrence rate was 2.5. It was considered that this prescription was effective in treating simple hepatic cyst. Feasible. 2) safe, simple, simple and convenient. The operation method of sclerotherapy under the guidance of B-ultrasound in the treatment of simple hepatic cyst was performed under local anesthesia and dynamic observation of ultrasound. The operation process was accurate and intraoperative. The cost of this method is much lower than that of surgical treatment, and the patient's financial burden is low. The vast majority of patients can give a good combination of trauma small B ultrasound guide absolute alcohol sclerosis treatment of simple hepatic cyst is a minimally invasive operation, at the same time, the surgical wound is small, reducing the postoperative wound infection rate. It has been replaced by surgical traumatic surgery, which is more widely used in the population. 5) the patients can walk quickly on the second day after operation, without affecting the normal life of the patients.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R575

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本文編號(hào)：1894492