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。     

超声引导下经皮经肾穿刺治疗肾脓肿

超声引导下穿刺治疗肾脓肿，因其损伤小、费用低、并发症少，能清晰显示脓腔在肾内的位置，可以确定皮肤穿刺进针点、进针角度及进针深度，从而大大提高了穿刺的成功率，同时还可以避免手术创伤给患者带来的痛苦，缩短病程，故得到广泛应用。本研究采用超声引导下经皮经肾穿刺治疗肾脓肿患者13例，经穿刺抽脓液、冲洗、注药或置管引流后治愈率为100％。现将结果报道如下。     

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。     

术后腹腔脓肿超声引导穿刺治疗10例

术后腹腔脓肿超声引导穿刺治疗１０例江苏省常熟市第一人民医院外科（２１５５００）范波腹腔脓肿是腹部手术后并发症之一，临床上常见为膈下脓肿、肠间隙脓肿、盆腔脓肿，以往若非手术治疗无效，常需手术切开排脓、冲洗、引流。随着超声医学的发展，介入性超声已广泛应用...     

超声引导下穿刺抽吸置管治疗肝、肾脓肿

目的评价超声引导下穿刺抽吸、置管治疗肝肾脓肿的效果.方法对39例肝肾脓肿患者共39个脓腔进行穿刺抽脓、冲洗、注药或穿刺置管引流、定时冲洗、注药治疗.结果32例患者行穿刺抽脓冲洗注药1～3次;7例患者行穿刺置管引流冲洗注药.穿刺及置管成功率均达100%.经超声复查,39例患者脓肿完全吸收,全部痊愈.结论超声引导下穿刺抽吸及置管术是一种疗效显著、安全、微创的治疗方法,具有重要的临床应用价值.     

超声引导下穿刺治疗肾脓肿的临床应用

目的探讨超声引导下穿刺治疗肾脓肿的临床应用价值。方法21例肾脓肿患者行超声引导下穿刺冲洗,引流,局部保留抗生素。结果21例病例全部治愈,无相关并发症发生,效果良好。结论超声引导下穿刺治疗肾脓肿安全,疗效确切,具有良好的临床推广应用价值。     

穿刺抽脓治疗147例急性感染性脓肿的临床观察

穿刺抽脓治疗１４７例急性感染性脓肿的临床观察谢德固邬凤林华西医科大学附属第一医院中医外科我们把体表急性感染性脓肿和哺乳期急性感染性乳房脓肿，采用分层随机分组法，用穿刺抽脓再辅以清热解毒Ⅱ号冲洗脓腔的治法与中医传统的切开引流后再提脓、化腐、生肌的治法，...     

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。     

超声引导腹腔穿刺治疗阑尾脓肿

目的：对介入性B型超声显像诊断引导经皮腹腔穿刺治疗阑尾脓肿的探讨。方法：选择9例临床症状典型的阑尾脓肿病例，采用B型超声显像诊断定位，引导用细针进行腹腔穿刺，抽出脓液，然后注入相应的抗生素药液。每隔3～5天进行1次。结果：经过1～3次的治疗，临床症状消失，9例阑尾脓肿病例均获痊愈。1个月之后经过B型超声显像诊断复查，脓腔消失。结论：阑尾脓肿是急性阑尾炎常见的合并症。阑尾脓肿的治疗，其手术适应证很难掌握，而临床上往往倾向于保守疗法。保守治疗使患者的病程延长，而且可能导致脓肿破裂，形成腹膜炎，甚至危及患者的生命。数年来，我们对部分比较典型的病例，选择性地采用介入性B型超声显像诊断引导经皮腹腔穿刺的方法，取得了满意的疗效，报告如下。     

B超对肾周围脓肿的诊断及其临床意义

本文报告近４年来经Ｂ超确诊，ＣＴ、穿刺抽脓或切开引流证实的７例肾周围脓肿患者的声像图特点和临床表现，进一步探讨Ｂ超对肾周围脓肿的诊断及其临床意义。本组７例，男４例，女３例，年龄２０～９１岁，平均５２岁。肾区均有叩痛，均有白细胞升高，尿常规发现白细胞４...     

肾自截伴流注脓肿1例报道并文献回顾

目的 了解肾结核导致流注脓肿患者的临床表现、诊断、治疗及预后.方法 对川北医学院附属医院骨科诊断的1例肾自截伴流注脓肿患者的临床表现、实验室及影像学检查、治疗和预后进行分析,并回顾和总结国内外迄今为止关于肾结核致腰大肌脓肿的文献报道.结果 该例71岁女性患者以腰背部疼痛伴右臀部、右大腿根部包块处红肿热痛为主要症状,有低...     

Upper urinary tract infection: the current role of CT, ultrasound, and MRI

This article reviewed some of the fundamental concepts in renal inflammatory disease. The difficulties in present terminology were reviewed and our approach discussed. The pathological underpinning of the acute-subacute infections were contrasted with those seen in the granulomatous diseases. The importance of CT in separating emphysematous pyelonephritis from emphysematous pyelitis and perinephric emphysema was stressed. Although ultrasound has been used in the past and is still of value in select situations, we prefer CT for assessment of renal infection. CT examinations show whether the disease is focal or diffuse, whether air is present, whether there is perinephric or pararenal extension, whether an abscess is present, and when the ideal time is for intervention. In severe renal infection in the adult, CT has shown the development of renal scars, perinephric extension, and the spontaneous drainage of Staphylococcus abscesses into nearby calyces.     

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.     

B超诊断脊椎结核合并椎旁脓肿36例分析

目的 :分析脊椎结核合并椎旁脓肿的声像图表现 ,探讨 B超在诊断脊椎结核合并椎旁脓肿中的诊断价值。方法 :对 3 6例脊椎结核患者进行多方位探查 ,将合并有椎旁脓肿者其 B超结果与引流物细菌培养结果对照。结果 :经临床治疗及引流物细菌培养结果证实 ,3 6例脊椎结核患者中 ,19例为腰椎结核 (53 % )。 14例为胸椎结核 (3 9% )。 3例为胸、腰椎结核 (8% )。合并有椎旁脓肿者 3 2例 (89% )。结论 :超声检查对脊椎结核合并椎旁脓肿的诊断具有较高的临床应用价值 ,为决定治疗方案提供依据     

超声显像在脊椎结核脓肿诊断中的应用

目的：探讨超声显像对脊椎结核脓肿的诊断价值。方法：对超声诊断的274例脊椎结核所致的寒性脓肿进行回顾性分析,并与手术病理对照。结果：超声诊断符合率97.4%(267/274),超声分期诊断准确率：进展期74.0%(77/104),好转期81.8%(139/170)。结论：超声显像对脊椎结核脓肿的诊断有较高的临床应用价值,为临床手术时机的选择提供依据。     

超声引导经皮穿刺肾脏组织活检术的安全性研究

目的探讨超声引导下经皮肾脏组织活检术的安全性及应用价值。方法分析2361例经皮肾组织活检的成功率和并发症的发生率及其导致原因。结果术后并发症24例,占发生率1．02％,其中重度2例,轻度22例。单纯肉眼血尿10例,肾周中小血肿8例,血尿同时有肾周中小血肿4例。结论超声引导下经皮肾脏组织活检术安全、并发症少,是肾脏疾病诊断、指导治疗、判断预后不可缺少的低风险的微创性检查技术。     

超声引导穿刺在普通外科中的应用

目的　探讨高频超声在乳腺隐匿性病灶检出、超声引导穿刺定位切除活检和乳腺囊肿穿刺治疗的应用价值。同时介绍腹腔脓肿与积液的超声引导穿刺引流,超声引导PTCD。方法　1993年至今共检出乳腺隐匿性病灶250处,并在超声引导下作穿刺定位病灶切除术。对30处乳腺囊肿在超声引导下作穿刺治疗。5例腹腔脓肿、积液患者在超声引导下作穿刺引流。4例梗阻性黄疸患者在超声引导下行PTCD。结果　高频超声对乳腺隐匿性肿瘤诊断符合率为90%。同时检出9例隐匿性乳腺癌。5例腹腔脓肿、积液患者4例通过穿刺引流治愈。4例PTCD者3例引流成功。结论　超声为乳腺隐匿性病灶的检出、手术定位和囊肿穿刺治疗提供了有效手段。腹腔积液或脓肿超声下穿刺引流是一有效的非手术治疗,超声为PTCD提供了又一有效的引导方法。     

Value of ultrasonography, fine needle aspiration, and percutaneous drainage of perinephric abscesses

With the advent of ultrasonography, perinephric fluid collection can be easily diagnosed and confirmed by fine needle aspiration. In the past these cases sometimes went undiagnosed for several months. We did fine needle aspiration under the guidance of ultrasonography in 16 patients without complications. The aspirant in 12 patients was purulent, confirming the diagnosis of perinephric abscess. In the remaining four the aspirated fluid was nonpurulent and the diagnosis was urinoma or hematoma. Percutaneous drainage was established in five of the 12 patients. The technique is safe and easy to perform, and may be the only treatment necessary in selected cases, thus avoiding unnecessary surgery and prolonged hospitalization.     

Complications of renal transplantation and the role of interventional radiology.

As rejection therapy has improved, the interventional complications of renal transplantation have increased in relative importance as potentially reversible causes of graft malfunction and failure. Ultrasonically guided aspiration and drainage techniques are essential for the characterization and subsequent management of perinephric fluid collections that occur in as many as 51% of cases, of which up to 18% may be clinically significant. In a series of 507 consecutive renal transplants, urological complications were seen in 9% of patients, consisting of ureteric obstruction in 6% and urinary leaks in 3%. Detection via ultrasound scanning, evaluation via antegrade pyelography and pressure-flow tests, and management via percutaneous nephrostomy and ureteric stenting all contribute to rapid diagnosis and subsequent treatment. Serial ultrasound scanning of renal transplants and the aggressive use of interventional radiological techniques are vital to the early detection and management of complications, and can lead to preservation of graft function and continued improvement in graft survival figures.     

A case with fistula formation between a perinephric retroperitoneal abscess and the duodenum: successful outcome after conservative management

A 67-year-old woman diagnosed with pyonephrosis and perinephric abscess because of an impacted urinary stone in the pelvicoureteric junction was admitted to the hospital with a high-grade fever. Although construction of a right nephrostomy for drainage of the abscess improved her general condition, she had a fever again 2 weeks after the initial treatment. Computed tomography revealed a persistent perinephric retroperitoneal abscess and a second drainage procedure was performed. Then, imaging examination revealed fistula formation between the cavity of the perinephric retroperitoneal abscess and the duodenum. The patient received conservative management including percutaneous drainage, discontinuation of oral intake, and antimicrobial chemotherapy. Three days after the second drainage and discontinuation of oral intake, imaging examination revealed complete closure of the fistula. Fistula formation between a perinephric abscess and the duodenum is very rare but a favorable outcome was obtained by our conservative management.