肾囊肿三种治疗方法的临床对照分析.doc

肾囊肿三种治疗方法的临床对照分析 邱来春 张志永 王欢 余武亮 郭文凤 沈柏华 [摘要] 目的 探讨B超定位经皮穿刺硬化术、腹腔镜去顶术和传统开放手术治疗肾囊肿的临床价值。 方法 回顾性分析2000年5月至2008年5月96例肾囊肿患者资料，其中B超定位经皮穿刺硬化术52例，腹腔镜去顶术25例，传统开放手术19例。对临床疗效、住院时间、愈后及费用进行对比研究。 结果 B超定位经皮穿刺硬化术安全简便、费用低、痛苦小，但远期复发率较高。腹腔镜组创伤小、恢复快、疗效可靠。传统开放手术创伤大、恢复慢但疗效可靠。 结论 不同方法治疗肾囊肿各有千秋。从疗效考虑，腹腔镜为首选。从费用和痛苦考虑，B超定位经皮穿刺硬化术为首选。 [关键字] 肾囊肿 B超 腹腔镜 [Abstract] Objective To investigate the ultrasoundguided percutaneous sclerotherapy, laparoscopic de-roofing and traditional lumbar incision for the clinical value of renal cysts. Methods A retrospective study from May 2000 to May 2008 ,96 patients of renal cysts in our hospital, including 52 cases by ultrasoundguided percutaneous sclerotherapy, 25 cases by laparoscopic deroofing ,19 cases by traditional lumbar incision. a comparative study is the clinical effectiveness, length of Hospitalization, the cost and Prognosis. Results It was safe and easy, low cost, less pain with ultrasoundguided Percutaneous sclerotherapy, but the long-term relapse rates are higher. Laparoscopic group, the trauma was minor, quick recovery, showing the operation was effective and reliable. The wounds of traditional lumbar incision was large, slow recovery, but effective and reliable. Conclusions The three different treatment of renal cysts has its advantages and disadvantages. From the clinical effectiveness , laparoscopic is the first choice. From a cost and pain to consider, ultrasoundguided percutaneous sclerotherapy is the first choice. [Keywords] ultrasoundguided ； renal cyst ；laparoscopy 肾囊肿是比较常见的泌尿系疾病，过去的治疗方法多为手术开刀治疗。近年来随着影像学技术的发展和介入性手术的开展，以及腹腔镜技术的发展，经B超定位肾囊肿穿刺硬化术和后腹腔镜下肾囊肿去顶术成为行之有效的方法。本文回顾性分析2000年5月至2008年5月96例肾囊肿治疗情况，现将相关质料比较如下。 临床资料与方法 一般资料 B超定位穿刺组:男40例,，女12例。年龄26-68岁，平均43.8岁。左侧肾嚢肿25例，右侧肾囊肿21例，双侧肾囊肿6例。囊肿直径5~14.2cm，平均7.2cm。 腹腔镜组：男11例，女14例。年龄32~71岁，平均51.6岁。左侧肾嚢肿8例，右侧肾囊肿17例。囊肿直径4.6~12cm，平均6.8cm。其中两例为B超穿刺硬化术后复发予后腹腔镜处理归入本组。 开放手术组：男6例，女13例。年龄35~60岁，平均46岁。左侧肾嚢肿11例，右侧肾囊肿8例。囊肿直径5.5~14cm，平均6.6cm。 全部病例术前均经B超、IVP、CT证实为单纯性肾囊肿。96例患者中有4