Objective To investigate the influence of last retention time of percutaneous injection of ethanol irrigation on ultrasound-guided anhydrous ethanol rinse in treatment of simple hepatic cyst. Methods A total of 180 simple hepatic cyst patients were divided into groups A (n = 90, with cysts in 3 ~ 5 cm in diameter), B (n = 90, with cysts in 6 ~ 8 cm), then subdivided, based on last retention time of ethanol irrigation, into groups A1, B1, A2, B2, A3, B3. Under guide of ultrasound, anhydrous ethanol rinse treatment was performed, 3 times, the ethanol amount of every rinse accounting constantly for 1/ 5 of total extracted cyst fluid, the retention time of the 4th rinse was 0 min in groups Al and B1, 3 min in groups A2 and B2, 10 min in groups A3 and B3. Adverse reactions were observed 2 h after puncture. Six months later, rechecks were given and untoward reaction recorded to judge the effects of subgroups. Results Groups A, B completed follow-ups without loss to follow cases. In group A1, 24 cured, 6 had effectiveness; in groups A2, A3 , all cured. There was not ineffectiveness in 3 subgroups, the difference was significant in effectiveness between subgroups (X2 = 12. 857, P < 0. 05); thereinto group Al was different from groups A2, A3 in curative rate (X2 = 4. 630, P < 0. 05). In group B1, 9 cured, 13 had effectiveness, 8 had no response; in group B2, 10, 12, 8, respectively; in group B3, 26, 4, 0, respectively; the difference was significant (H = 20. 380, P < 0. 05); thereinto groups B1, B2 different from B3 (average rank and difference = 26. 967 , 25. 733 , respectively, P <0. 05). The main adverse reactions were facial flushing, mild nausea, local pain, dizziness (dying away after 1 ~2 h), without allergies and other discomforts. No pneumothorax, bleeding, infection, bile leakage, shock and other serious complications appeared during follow -up. Conclusion For simple hepatic cyst patients with 3 ~5 cm cysts, the retention time of 3 min is enough for gaining satisfactory effectiveness, and for those with 6 ~ 8 cm, 10 min is needed. Patients have light adverse reactions without serious complications. The treatment is safe and feasible.%目的 探讨末次冲洗乙醇留置时间对超声引导下无水乙醇冲洗治疗肝囊肿疗效的影响.方法 选择2010年10月-2012年3月我科收治的单纯性肝囊肿患者180例,其中囊肿直径3～5 cm者90例(A组)、6～8 cm者90例(B组).根据末次冲洗乙醇留置时间将A、B组患者分为A1、B1组,A2、B2组、A3、B3组.超声引导下行无水乙醇冲洗治疗,维持单次冲洗乙醇剂量占抽出总囊液量的1/5不变,连续冲洗3次,A1、B1组第4次冲洗乙醇留置0 min,A2、B2组留置3 min,A3、B3组留置10 min.观察患者穿刺后2 h内出现的不良反应,6个月后复查并记录患者相关不良反应,判断各亚组患者的疗效.结果 A、B组患者均完成了随访,无失访病例.A1组治愈24例,有效6例;A2组和A3组患者全部治愈.3个亚组均未出现治疗无效患者,亚组间疗效差异有统计学意义(χ2=12.857,P＜0.05);其中A1组与A2组和A3组治愈率比较,差异均有统计学意义(χ2值均为4.630,P＜0.05).B1组治愈9例、有效13例、无效8例;B2组治愈10例、有效12例、无效8例;B3组治愈26例、有效4例、无效0例.3个亚组间疗效比较,差异有统计学意义(H=20.380,P＜0.05);其中B1组和B2组与B3组比较,差异均有统计学意义(平均秩和差为26.967和25.733,P＜0.05).A、B组患者穿刺不良反应主要为面色潮红、轻微恶心、局部胀痛不适、头昏,1～2 h后自行消失,未出现变态反应及其他不良反应;随访期间未出现气胸、大出血、感染、胆漏、休克等严重并发症.结论 囊肿直径3～5 cm的单纯性肝囊肿患者,超声引导下无水乙醇冲洗治疗末次乙醇留置3 min即可达到满意的疗效,囊肿直径6～8 cm者末次乙醇留置10 min疗效较好;患者不良反应较轻,无治疗相关的严重并发症出现,安全可行.
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