经皮穿刺引流治疗阑尾周围脓肿的临床应用

 目的评价经皮穿刺引流在阑尾周围脓肿治疗中的临床应用价值。方法将60例阑尾周围脓肿患者随机分成常规治疗组和经皮引流组，每组30例。常规治疗组采用抗生素全身抗感染及对症支持治疗;经皮引流组在全身抗感染及对症支持治疗基础上，经腹壁脓腔置管引流。结果经皮引流组第2周治愈率40.00%(12/30)、有效率90.00％(27/30)，第3周治愈率80.00%(24/30)、有效率96.67％(29/30)，与常规治疗组比较差异有统计学意义(P＜0.05或P＜0.01)，而且经皮引流组在体温恢复正常时间、血象恢复正常时间、脓腔消失时间、腹痛消失时间和抗生素使用时间方面明显优于常规治疗组(P＜0.01)。治疗期间经皮引流组无中转手术治疗病例。结论对液化相对完全且局限的阑尾周围脓肿，经皮穿刺引流可缩短疗程，提高疗效，是一种安全可靠的治疗方法。

Application of percutaneous puncture drainage in treatment of periappendiceal abscess

Objective To study the clinical value of percutaneous puncture drainage for periappendiceal abscess. Methods Sixty patients with periappendiceal abscess were divided into two groups (n=30): routine therapy group and percutaneous drainage group. The patients in the routine therapy group were administered antibiotics to take anti-infective and supportive trerapy, whereas the patients in the percutaneous drainage group were treated with the ways that in the routine therapy group but addition of catheter drainage. Results The cure rate in percutaneous drainage group was 40.00%(12/30) and the total effective rate was 90.00％(27/30)at the second week. Furthermore ,the cure rate in percutaneous drainage was 80.00%(24/30)and the total effective rate was 96.67％(29/30)at the third week. There was difference between the two groups in the curative ratio (P＜0.05 or P＜0.01).But the index such as the body temperature, WBC, abscess cavity, abdominal pain, and duration of antibiotic use in the percutaneous drainage group recovered to normal in less time than those in the routine therapy group(P＜0.01). No patients were treated with operation in percutaneous drainage group during treatment. Conclusions The drainage therapy under ultrasound or CT guiding for well-formed and localized periappendiceal abscess can increase the therapeutic effect, decrease the course of treatment. Therefore, it is a safe, simple and reliable method.