Efficacy of minocycline hydrochloride aspiration sclerotherapy with additional monoethanolamine oleate aspiration sclerotherapy for symptomatic hepatic cysts
Efficacy of minocycline hydrochloride aspiration sclerotherapy with additional monoethanolamine oleate aspiration sclerotherapy for symptomatic hepatic cysts
复制标题
盐酸米诺环素抽吸硬化疗法联合油酸单乙醇胺抽吸硬化疗法治疗症状性肝囊肿的疗效
DOI：
10.1111/hepr.13865
复制
发表时间：
2022
影响因子：
4.2
通讯作者：
Kataoka Hiromi
中科院分区：
文献类型：
--
作者：
Kimura Yoshihide;Fujiwara Kei;Matsuura Kentaro;Suzuki Takanori;Senoo Kyouji;Tsuchida Kenji;Mori Yoshinori;Hirano Atsuyuki;Nomura Satoshi;Kitagawa Mika;Tomita Yusaku;Kanaiwa Hiroki;Imazu Mitsuki;Nagura Yoshihito;Nojiri Shunsuke;Kataoka Hiromi
目的盐酸米诺环素（MINO）抽吸硬化疗法（AS）已广泛用于治疗肝囊肿（HC）。然而，囊肿复发仍然是个问题。目前有关另一种有效的 HC 治疗方法单乙醇胺油酸酯 (EO) AS 的信息有限。我们研究了 EO 对无效 MINO 治疗的疗效，以及 MINO AS 与囊液 pH 值之间的关系。方法从 2016 年 1 月至 2021 年 6 月，共有 22 例有症状的 HC 患者接受了 500 mg MINO AS 治疗。在 MINO 注射前后测量了囊液 pH 值。 2周后的囊肿体积比（CVR，%）计算如下：MINO注射后2周的囊肿体积/治疗前的囊肿体积×100。如果2周后的CVR≤35%，则治疗完成（MINO组）。对于 CVR > 35% 的患者，添加 2 g EO（MINO/EO 组）。此后每12个月测量一次囊肿体积比。结果随访期间所有患者均未出现复发症状。在 22 例病例中，12 个月后 21 例的 CVR ≤20%。 12 个月后，MINO/EO 组 (n=8) 的 CVR 往往比 MINO 组 (n=14) 更小。 2 周后囊肿体积比与 pH 值变化相关 (p=0.012)，并且 pH 值下降 <1.5 的患者囊肿体积比更大 (p=0.015)。所有不良事件都很轻微，包括老年患者。 结论 当单独使用 MINO AS 效果不佳时，添加 EO 是一种有效且安全的治疗症状性 HC 的方法。 pH 值下降<1.5 的患者应考虑接受额外的 EO 治疗。
AimMinocycline hydrochloride (MINO) aspiration sclerotherapy (AS) has been widely used for treating hepatic cysts (HC). However, cyst recurrence remains problematic. Information on monoethanolamine oleate (EO) AS, another effective HC treatment, is currently limited. We investigated the efficacy of EO on ineffective MINO treatments, and the relationship between MINO AS and cyst fluid pH.MethodsA total of 22 cases with symptomatic HC underwent AS with 500 mg of MINO from January 2016 to June 2021. Cyst fluid pH was measured before and after MINO injection. Cyst volume ratio (CVR, %) after 2 weeks was calculated as follows:cyst volume 2 weeks after MINO injection / pre‐treatment cyst volume × 100. Treatment was completed if CVR after 2 weeks was ≤35% (MINO‐group). For patients with CVR >35%, 2 g of EO was added (MINO/EO‐group). Cyst volume ratio was measured every 12 months thereafter.ResultsThere were no recurrence symptoms in any of the patients during follow‐up. Of the 22 cases, 21 had CVR ≤20% after 12 months. The MINO/EO‐group (n= 8) tended to have smaller CVRs after 12 months than the MINO‐group (n= 14). Cyst volume ratio after 2 weeks was correlated to pH change (p= 0.012) and was larger in patients whose pH decreased by <1.5 (p= 0.015). All adverse events were mild, including in elderly patients.ConclusionAdding EO is an effective and safe treatment for symptomatic HC when MINO AS alone is insufficient. Patients with pH decreases of <1.5 should be considered for additional EO treatment.