超声引导经皮穿刺治疗肾脓肿的临床意义

目的 探讨肾脓肿微创伤介入治疗方法。方法 超声引导下经皮穿刺对12例肾脓肿进行脓汁引流、脓腔冲洗、注药治疵细菌培养、药敏感试验、抗感染治疗。结果 细菌培养阳性7例，阴性5例，全部病例经1—4周治疗后痊愈，未发生并发症。结论 介入超声治疗肾脓肿安全有效、无并发症，值得推广应用。     

超声引导下细菌性肝脓肿13例介入治疗分析

目的：探讨超声引导下介入治疗肝脓肿的临床应用价值。方法：对13例肝脓肿在实时超声引导下经皮肝穿刺置管引流治疗。结果：13例均痊愈出院，一次穿刺置管成功率100％，无并发症。结论：超声引导下经皮肝穿刺置管引流治疗肝脓肿是一种安全可靠、简便经济、疗效确切的首选方法，值得临床推广应用。     

超声引导介入诊治肝脓肿的临床价值研究

目的：探讨B超引导下介入治疗肝脓肿的临床应用价值。方法：对147例门诊和住院肝脓肿患者实施B超引导下经皮肝穿刺抽吸或置管药物冲洗引流术，其中108例为单纯穿刺抽脓冲洗，39例为置管引流冲洗。结果：本组115例经超声诊断为肝脓肿，23例经CT诊断为肝脓肿，9例CT诊断为可疑的肝脓肿。147例均在超声引导下行经皮肿块穿刺抽吸术后证实为肝脓肿，经1～4次抽吸及注药治疗后，临床症状消失，复查示脓腔小于20mm，随访6个月均痊愈。结论：超声引导下穿刺诊治肝脓肿是一种安全、简便、经济、高效的方法，可作为临床治疗细菌性肝脓肿的首选方法，值得推广。     

不典型肝脓肿20例超声诊断及超声介入治疗分析

目的：探讨不典型肝脓肿超声诊断及介入治疗。方法：通过对20例肝脓肿进行超声诊断及随诊观察,进行超声介入治疗。结果：20例中超声确诊18例,误诊2例。典型病例11例,不典型者9例。19例超声介入治疗效果良好。结论：留意超声中的图像特征及合并的并发症影像可以提高肝脓肿的诊断率,而超声介入治疗是治疗肝脓肿的有效手段。     

超声引导经皮肝穿刺治疗细菌性肝脓肿56例临床分析

目的探讨细菌性肝脓肿的合理治疗方法。方法总结分析我们采用超声引导经皮肝穿刺治疗的56例细菌性肝脓肿的临床资料和治疗效果。结果脓液细菌培养阳性率为58％。诒疗操作时间15-30min，接受治疗后当天患者发热症状即明显缓解或消失，平均住院16d，治愈率100％，无严重并发症出现。结论超声引导经皮肝穿刺治疗细菌性肝脓肿具有微创、高效的特点，配合营养支持、抗生素使用、糖尿病控制是目前应该采取的治疗方法。     

普通超声探头引导经皮肝穿刺置管引流治疗肝脓肿

目的探讨普通超声探头引导经皮肝穿刺置管引流治疗肝脓肿的临床应用价值。方法对41例肝脓肿患者53个病灶行普通超声探头引导经皮肝穿刺置管引流术,直径〈50mm肝脓肿给予穿刺注药冲洗治疗,直径≥50mm肝脓肿行置管引流术。结果41例肝脓肿患者的53个病灶一次穿刺置管成功率100％,无并发症发生。穿刺置管抽液后患者体温即下降,有效率100％。2周治愈率达到65．9％,4周治愈率达到100％。结论利用普通探头引导进行穿刺置管引流治疗肝脓肿,具有安全有效、微创,费用低廉及操作简便、灵活的特点,值得推广应用：     

介入超声治疗肝脓肿的研究

目的 评价介入超声治疗肝脓肿的效果，探讨介入超声治疗肝脓肿的方法。方法 回顾性总结介入超声治疗肝脓肿59例。其中经皮穿刺抽脓术28例。经皮穿刺置管引流术15例，经皮穿刺两点双管引流术14例，前两种或三种方法配合治疗各1例。结果 59例全部治愈，仅穿刺置管引流术组有1例出现胆瘘。穿刺抽脓可用于治疗直径小于5cm的肝脓肿，直径在5锄以上者均可用经皮穿刺置管引流术，巨大肝脓肿行经皮穿刺两点双管引流术与外科手术有相同疗效。结论 介入超声治疗肝脓肿简便、安全、创伤小、费用少、住院时间短、并发症和死亡率低。     

实时B型超声导向下治疗肝脓肿（附95例分析）

本文报告95例肝脓肿在使用抗菌素的同时．采用超声导向下抽吸脓腔、冲洗、置药及置管引流进行治疗。其中细菌性肝脓肿90例．单发79例，多发11例．阿米巴肝脓肿5例。经穿刺、抽吸、冲洗，置药治疗者92例，男3例抽暖、冲洗，置药并置管引流治疗，疗效迅速．治愈率达100％．本组无并发症出现，超声导向下脓腔抽吸、冲洗、置药及置管引流术，病人痛苦小，疗效高，安全可靠，是治疗肝脓肿的首选方法。     

实时超声引导下经皮穿刺置管引流治疗细菌性肝脓肿

本文报告细菌性肝脓肿13例,单发9例,多发4俐,均在使用抗菌素的同时,在实时超声引导下经皮经肝穿刺抽吸或置管引流进行治疗。经穿刺抽脓治疗者7例,置管引流治疗者2例,另4例经穿刺1～3次后转手术切开引流治疗。本组无并发症出现。作者认为实时超声引导下经皮经肝抽吸或置管引流术对病人痛苦少,疗效高,安全可靠,是治疗细菌性肝脓肿的首选方法。     

彩色多普勒超声引导介入治疗肝脓肿33例分析

目的探讨彩色多普勒超声引导下经皮肝穿刺治疗肝脓肿的临床价值。方法回顾性分析经彩色多普勒超声诊断并引导行介入治疗的33例肝脓肿患者的诊治过程。结果 33例经彩色多普勒超声诊断并引导行介入治疗的患者中,9例好转,24例治愈出院。结论彩色多普勒超声引导介入治疗肝脓肿是一种安全、经济、简便、操作时间短、患者痛苦小、疗效明显,是临床首选的治疗方法。     

超声在细菌性肝脓肿诊断及治疗中的应用

[目的]探讨分析细菌性肝脓肿的超声表现及超声诊断技术和介入性治疗的临床应用价值.[方法]回顾性分析经临床随访及超声引导下穿刺活检证实76例细菌性肝脓肿临床及影像学资料.[结果]肝脓肿随病理过程的变化临床及超声表现各不同,超声引导下穿刺活检可确诊,大部分可行超声引导下脓肿穿刺抽吸或置管引流,结合全身治疗,可使病程缩短.[结论]肝脓肿声像图复杂多变,超声仍为首选方法,超声引导下穿刺更具诊断意义,超声引导下穿刺引流疗效显著.     

超声引导下经皮肝穿刺治疗细菌性肝脓肿的临床价值

目的评价超声引导下经皮肝穿刺治疗细菌性肝脓肿的临床应用价值。方法对临床确诊为细菌性肝脓肿的49例患者进行超声引导下经皮肝穿刺治疗,其中22例行单纯细针抽吸术（抽吸组）,26例行置管引流术（置管组）,1例抽吸术后1周脓腔无明显缩小而行置管引流术（抽吸＋置管组）;同时配合静脉抗炎、全身支持治疗。结果超声引导下经皮肝穿刺细针抽吸或置管引流治疗后,患者体温恢复正常、白细胞计数恢复正常及脓腔消失时间分别为（2.8±0.6）d、（3.2±0.5）d、（14.6±4.2）d。所有患者均无并发症,术后3个月复查超声脓腔均消失,超声引导下经皮肝穿刺治疗细菌性肝脓肿的治愈率为100%。结论超声引导下经皮肝穿刺细针抽吸和置管引流术具有简便经济、创伤小、并发症低、治愈率高等优点,成为细菌性肝脓肿首选治疗方法。     

Percutaneous management of breast abscesses. An experience of 39 cases

This is a review of our experience with percutaneous drainage by means of needle aspiration or catheter drainage of breast abscesses under ultrasound (US) guidance, and a suggested management algorithm. A retrospective study of the 39 patients (36 women, 3 men; mean age: 28.9 years) with breast abscesses who were treated by percutaneous US-guided procedures over a period of 13 years (1989 to 2002) was carried out. Of the 36 women, 34 were nonlactating and two lactating. Needle aspiration was used in the cases of fluid collections < or = 3 cm and catheter drainage in fluid collections of > 3 cm. Postdrainage care and US evolutive controls were carried out on an outpatient basis. Fine-needle aspiration cytology was performed in masses unresolved after postdrainage. Mammography was performed in patients over 30 years old. In all cases, US examination revealed images of fluid collection. A single needle aspiration was sufficient in 19 cases; 3 patients needed a second aspiration to resolve the breast abscess. A total of 15 cases were resolved by means of percutaneous catheter drainage. In 2 of the 17 patients who underwent catheter drainage, the mass persisted postdrainage; histologic findings showed a chronic abscess requiring surgical intervention in one and a breast carcinoma in the second. Mean follow-up was 8.4 months. Recurrence of breast abscess occurred in 4 patients, and these were resolved by surgical excision. Percutaneous drainage procedures in breast abscesses are a safe and effective alternative to incision and drainage. Needle aspiration is employed in cases of small abscesses and catheter drainage in abscesses larger than 3 cm. Although, in chronic abscesses, the treatment of choice is surgical excision, percutaneous drainage remains as an intermediate therapeutic option.     

Hepatic abscesses in immunocompromised patients: Ultrasonically guided percutaneous drainage

Ultrasonically guided percutaneous drainage (US-PD) is considered first-line therapy for hepatic abscesses, but no data are available on its efficacy in severely immunocompromised patients. Therefore, we examined 15 such patients in whom one or more hepatic abcesses of different etiology were treated with US-PD. Eleven patients underwent needle aspiration and four had catheter drainage under US guidance. In 12 cases we achieved complete healing of the abscesses. In one case, clinical improvement was obtained but surgery was required for cure. In another case (fungal abscess in AIDS), we had no improvement and the patient died. No procedural complications were observed. Seven patients died during the follow-up periods of up to 49 months from their underlying disease. We conclude that US-PD must be considered the therapy of choice for hepatic abscess (except the fungal lesions) in severely immunocompromised patients.     

The role of sonography in imaging of the biliary tract

Sonography is the recommended initial imaging test in the evaluation of patients presenting with right upper quadrant pain or jaundice. Dependent upon clinical circumstances, the differential diagnosis includes choledocholithiasis, biliary stricture, or tumor. Sonography is very sensitive in detection of mechanical biliary obstruction and stone disease, although less sensitive for detection of obstructing tumors, including pancreatic carcinoma and cholangiocarcinoma.In patients with sonographically documented cholelithiasis and choledocholithiasis, laparoscopic cholecystectomy with operative clearance of the biliary stone disease is usually performed. In patients with clinically suspected biliary stone disease, without initial sonographic documentation of choledocholithiasis, endoscopic ultrasound or magnetic resonance cholangiopancreatography is the next logical imaging step. Endoscopic ultrasound documentation of choledocholithiasis in a postcholecystectomy patient should lead to retrograde cholangiography, sphincterotomy, and clearance of the ductal calculi by endoscopic catheter techniques.In patients with clinical and sonographic findings suggestive of malignant biliary obstruction, a multipass contrast-enhanced computed tomography (CT) examination to detect and stage possible pancreatic carcinoma, cholangiocarcinoma, or periductal neoplasm is usually recommended. Assessment of tumor resectability and staging can be performed by CT or a combination of CT and endoscopic ultrasound, the latter often combined with fine needle aspiration biopsy of suspected periductal tumor.In patients whose CT scan suggests hepatic hilar or central intrahepatic biliary tumor, percutaneous cholangiography and transhepatic biliary stent placement is usually followed by brushing or fluoroscopically directed fine needle aspiration biopsy for tissue diagnosis.Sonography is the imaging procedure of choice for biliary tract intervention, including cholecystostomy, guidance for percutaneous transhepatic cholangiography, and drainage of peribiliary abscesses.     

B超引导下穿刺置管引流术治疗肝脓肿22例临床分析

目的 探讨超声引导下经皮肝穿刺抽脓或置管引流在细菌性肝脓肿的临床应用价值。方法对22例细菌性肝脓肿通过超声引导确定后进行穿刺抽脓或置管引流,其中4例行穿刺抽脓1次,21例行置管引流。结果22例穿刺、置管全部获成功,平均疗程20d（10～42d）。术后无腹腔内出血、气胸、脓胸及严重腹腔感染等并发症。结论B超引导下肝脓肿穿刺置管引流术具有简便、安全、住院时间短、费用少,并发症低的优点,可用于治疗大多数肝脓肿。     

Nonsurgical management of thyroid abscess with sonographically guided fine needle aspiration

Treatment of thyroid abscess commonly includes the surgical drainage along with systemic antibiotic therapy. Alternatives for open surgical intervention may be the conservative management with use needle aspiration or catheter drainage. We report here two cases of thyroid abscess treatment with 21-gauge needle aspiration under ultrasound guidance. In each case needle drainage was performed twice, at the 1st and 5th day of admission. Antibiotics were administered in pills and injected into the abscess cavity followed the pus aspiration and lavage. Both patients were cured. Follow-up has not revealed recurrence during 6 month and 5 years.     

超声引导经皮经肝穿刺胆管置管引流术(附159例报告)

目的探讨超声引导下经皮经肝穿刺胆管置管引流术(PTCD)的临床应用价值。方法159例梗阻性黄疸病人,其中肝癌84例,胰头癌31例,胆管癌19例,胃癌肝转移12例,胆囊癌13例,在超声引导下经皮经肝胆管穿刺置管引流术178次。结果肝总管内置管86支,右肝管内置管41支,左肝管内置管51支,导管置入失败3支,PTCD成功率98%。结论超声引导下PTCD定位准确,成功率高,是较为安全、有效、病人易接受的胆道减压引流方法。     

超声引导下经皮穿刺治疗的临床应用价值

目的：探讨超声引导下经皮穿刺治疗各部位占位病变的临床应用价值。方法：对79例各部位占位性病变行超声引导下经皮穿刺治疗。其中11例为失支手术机会的癌肿病人,实行癌肿内直接注射无水乙醇和（或）抗癌药物。55例囊性肿块行穿刺抽液注入硬化剂治疗。6例梗阻性黄疸行超声引导下经皮经肝穿刺胆管引流术。8例肝脓肿行穿刺置管引流术。结果：11例手术手术机会的癌肿病人治疗后1、2年生存率分别为72.7％,45.5％。疗效肯定。55例囊性肿块治疗后随访6个月－3年,治愈率达87.0％（47／54）,总有效率100％,其中1例操作失误未完成治疗。6例阻塞性黄疸行PTBD及8例肝脓肿病人穿刺置管引流后临床症状迅速改善,疗效显著。结论：超声引导下穿刺治疗术在各部位占位性病变的治疗中有其独特的临床应用价值,值得推广。