标题：CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿疗效比较

      作者：张红梅 1，陈晨 1，陈凯 1，刘豆豆 1，姜健 1，王艳茹 2    蒲城县医院医学影像科 1、内分泌肾病科 2，陕西 渭南 715500

      卷次： 2020年31卷24期

      【摘要】 目的 探讨CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿的临床疗效。方法 选择2018年1月至2019年1月在蒲城县医院诊治的104例肾盂旁囊肿患者为研究对象。按照随机单双数法将所有患者分为对照组和观察组各52例。对照组患者予以CT引导下无水乙醇置换术治疗，观察组患者予以CT引导下聚桂醇注射治疗。治疗后6个月，比较两组患者的临床疗效、不良反应及治疗后15个月的复发率，并比较两组患者术前、术后12 h及术后24 h的血清皮质醇(COR)、肾上腺素(AD)、去甲肾上腺素(NE)及血管紧张素(AngⅡ)等应激指标水平。结果 观察组患者的临床治疗总有效率为94.23%，明显高于对照组的78.85%，差异有统计学意义(P<0.05)；两组患者术后12 h的血清COR、AD、NE及AngⅡ水平均明显高于术前，术后24 h血清COR、AD、NE及AngⅡ水平均明显低于术后 12 h，且观察组患者术后 24 h血清COR、AD、NE及AngⅡ水平分别为(211.72±21.65) ng/mL、(0.22±0.04) ng/mL、(270.61±27.03) ng/mL、(56.73±5.25) pg/mL，明显低于对照组的(230.73±23.15) ng/mL、(0.31±0.05) ng/mL、(315.38±30.31) ng/mL、(66.80±6.22) pg/mL，差异均有统计学意义(P<0.05)；观察组患者的不良反应发生率及复发率分别为7.69%、3.85%，明显低于对照组的36.54%、32.69%，差异均有统计学意义(P<0.05)。结论 CT引导下无水乙醇置换术与聚桂醇硬化剂治疗肾盂旁囊肿患者均有一定疗效，但CT引导下聚桂醇注射进行治疗的效果更为显著，对患者造成的应激反应较小，且能明显减少其不良反应及复发。
      【关键词】 肾盂旁囊肿；CT引导；无水乙醇；聚桂醇；硬化剂；应激；疗效
      【中图分类号】 R692.7 【文献标识码】 A 【文章编号】 1003—6350（2020）24—3181—04

Comparison on the curative effect of CT-guided absolute ethanol replacement and polycinnamyl alcoholhardener in the treatment of parapelvic cysts.
ZHANG Hong-mei 1, CHEN Chen 1, CHEN Kai 1, LIU Dou-dou 1, JIANGJian 1, WANG Yan-ru 2. Department of Medical Imaging 1, Department of Endocrinology and Nephrology 2, Pucheng CountyHospital 1, Weinan 715500, Shaanxi, CHINA
【Abstract】 Objective To investigatethe clinical efficacy of CT-guided absolute ethanol replacement and poly-cinnamyl alcohol hardener in the treatment of parapelvic cysts. Methods A total of 104 patients with parapyelic cystswho were medically diagnosed and treated in Pucheng County Hospital from January 2018 to January 2019 were select-ed as the research subjects. According to the random odd and even number method, the patients were divided into a con-trol group and an observation group, with 52 patients in each group. The patients in the control group were treated withCT-guided anhydrous ethanol replacement, and the patients in the observation group were treated with CT-guided poly-cinnamyl alcohol injection. At 6 months after treatment, the clinical efficacy, adverse reactions, and recurrence rate at15 months after treatment were compared between the two groups, and the levels of stress indicators such as serum cor-tisol (COR), adrenalin (AD), norepinephrine (NE), and angiotensin hormone (AngⅡ) were compared between the twogroups before operation, 12 h after operation, and 24 h after surgery. Results The total effective rate in the observa-tion group was 94.23%, which was significantly higher than 78.85% of the control group (P<0.05); the serum COR,AD, NE, and AngⅡ levels of the two groups at 12 hours after surgery were significantly higher than those at beforesurgery, and the levels at 24 hours after surgery were significantly lower than those at 12 hours after surgery; the levelsof serum COR, AD, NE, and AngⅡ at 24 hours after surgery in the observation group were (211.72±21.65) ng/mL,(0.22±0.04) ng/mL, (270.61±27.03) ng/mL, (56.73±5.25) pg/mL, which were significantly lower than (230.73±23.15) ng/mL,(0.31±0.05) ng/mL, (315.38±30.31) ng/mL, (66.80±6.22) pg/mL in the control group (P<0.05). The incidence and recur-rence rates of adverse reactions in the observation group were 7.69% and 3.85%, which were significantly lower than36.54% and 32.69% of the control group (P<0.05). Conclusion Both CT-guided anhydrous ethanol replacement andpolycinnamyl alcohol hardener have a certain effect on the treatment of patients with parapelvic cyst, but the CT-guidedpolycinnamyl alcohol injection has a more significant effect on the treatment of parapelvic cyst patients, causing signifi-cantly less stress response to the patients, adverse reactions, and recurrence.
      【Key words】 Parapelvic cyst; CT-guided; Absolute ethanol; Polycinnamyl alcohol; Hardener; Stress; Efficacy