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目的探讨彩超引导下经皮穿刺对单囊型肝包虫病的治疗价值。方法改变将穿刺针一次进入囊腔的做法,在彩超引导下,经皮先将穿刺针的针尖接触或接近到包虫囊的外囊壁,拔出针芯,连接引流管,将空芯针快速刺入包虫囊的中心,(这样在穿刺针进入囊腔的过程中,由于囊内的压力和张力增大,包虫液就会顺着空心针流出来,从根本上解决了包虫液外漏引起的过敏和种植)。抽尽囊液后,按抽出量的20%~70%分别注入无水乙醇和22.5%的高渗盐水于腔内进行治疗,最后腔内保留一定量的无水乙醇,拔针后立即改变体位180°(这样做是为了让保留于腔内的无水乙醇随重力首先接触到穿刺针进入囊腔的那一部分),6min后,再反复改变体位,使保留于腔内的无水乙醇充分地接触到内囊内壁的每一部分,达到彻底杀死残留于腔内的包虫头节的目的结果42例单囊型肝包虫病患者均一次穿刺成功,治疗后1个月、3个月、6个月,9个月复查,以后每年复查,最长1例达8年,囊肿逐渐缩小,直至纤维化和钙化。结论彩超引导下经皮穿刺改良治疗单囊型肝包虫病,是一种简便易行、安全实用、创伤轻微、疗效可靠的新方法。
Objective To investigate the value of percutaneous puncture guided by color Doppler ultrasonography in the treatment of unilateral cystic echinococcosis. Method to change the puncture needle into the cyst cavity approach, under the guidance of ultrasound, percutaneous needle tip first contact or close to the outer wall of the hydatid cyst, pull out the needle core, connect the drainage tube, the hollow core needle Rapid penetration into the center of the hydatid cyst, (so that the puncture needle into the cysts in the process, due to the pressure and tension within the cyst increases, hydatid fluid will flow down along the hollow needle, a fundamental solution to hydatid Liquid leakage caused by allergies and planting). After pumping off the cyst fluid, 20% to 70% of the amount of extraction were injected with ethanol and 22.5% hypertonic saline in the cavity for treatment, the last cavity to retain a certain amount of ethanol, needle immediately after the change of position 180 ° (this is done so that the remaining ethanol in the cavity gravitationally first contact with the puncture needle into the cyst that part), 6min, and then repeatedly change body position so that the retention of alcohol in the cavity fully To reach each part of the inner wall of the inner capsule to achieve the purpose of completely killing the head of the echinococcosis remaining in the cavity.Results The successful puncture of 42 cases of single-capsular hydatid disease was successful at one month, three months, 6 months, 9 months review, after the annual review, up to 1 case up to 8 years, the cyst gradually reduced until the fibrosis and calcification. Conclusion Percutaneous puncture guided by color Doppler ultrasonography is an effective and safe method for the treatment of unicytic hepatic hydatid disease. It is a safe and practical method with minimal trauma and reliable curative effect.