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。     

超声引导下经皮穿刺置管引流术治疗老年细菌性肝脓肿的临床效果观察

研究超声引导下经皮穿刺置管引流术治疗老年细菌性肝脓肿的临床效果。纳入老年细菌性肝脓肿患者94例,根据随机数字表法均分为切开组和超声组。切开组采用细菌性肝脓肿切开置管引流治疗,超声组采用超声引导下经皮穿刺置管引流术治疗。比较两组总有效率、体温复常时间、脓腔消失时间、血象复常时间、住院时间及并发症发生率的差异。超声组总有效率显著高于切开组(P0.05);超声组相较于切开组体温复常时间、脓腔消失时间、血象复常时间、住院时间更短(P0.05);超声组相较于切开组并发症发生率更低(P0.05)。超声引导下经皮穿刺置管引流术治疗老年细菌性肝脓肿的临床效果确切,可有效促进体温和血象恢复正常,减少并发症发生,缩短脓腔消失时间和住院时间,值得推广运用。     

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。     

超声引导下经皮穿刺置管引流术与腹腔镜肝脓肿切开引流术治疗细菌性肝脓肿患者对比观察

目的:对比超声引导下经皮穿刺置管引流术与腹腔镜肝脓肿切开引流术治疗细菌性肝脓肿的效果。方法:选取我院2016年2月—2018年1月细菌性肝脓肿患者72例,根据治疗方案分为超声组(n=36)与腹腔镜组(n=36)。腹腔镜组采取腹腔镜肝脓肿切开引流术,超声组采取超声引导下经皮穿刺置管引流术。统计两组围术期状况、并发症发生率。结果:超声组手术时长、住院时长、体温恢复正常用时、白细胞计数恢复正常用时短于腹腔镜组(P0.05);超声组并发症发生率(5.56%)低于腹腔镜组(22.22%,P0.05)。结论:采取超声引导下经皮穿刺置管引流术治疗细菌性肝脓肿,效果优于腹腔镜肝脓肿切开引流术,术后康复较快,且并发症发生率较低。     

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。     

超声引导经皮穿刺置管引流治疗细菌性肝脓肿36例疗效分析

目的：探讨细菌性肝脓肿经皮肝穿刺置管引流的处理方法,评价其临床应用效果。方法：超声引导下采用同轴改良技术经皮肝穿刺置管引流治疗细菌性肝脓肿36例。结果：36例共40个脓腔,全部治愈,平均置引流管7．5d,无死亡及严重并发症发生。结论：超声引导经皮穿刺置管引流治疗细菌性肝脓肿具有简便易行、患者痛苦少、成功率高、治疗费用低廉等优点。     

超声引导穿刺抽吸和/或置管引流治疗细菌性肝脓肿

目的:探讨超声引导穿刺抽吸和/或置管引流治疗细菌性肝脓肿的临床应用价值。方法:对细菌性肝脓肿患者39例51个病灶实施超声引导下经皮穿刺,5cm的肝脓肿直接穿刺抽吸治疗,5cm的肝脓肿置管引流。结果:27例脓肿5cm者,1次抽吸治愈率85.2%(23/27),2次抽吸治愈率占14.8%(4/27)。12例脓肿5cm者行置管引流治疗,患者均在穿刺引流24～48h后体温降至正常,临床症状改善。结论:超声引导穿刺置管引流治疗细菌性肝脓肿安全、简便、有效,可作为临床治疗细菌性肝脓肿的首选方法。     

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。     

介入超声治疗肝脓肿临床价值研究

目的 总结分析超声引导下经皮肝穿刺治疗肝脓肿的临床应用价值.方法 29例肝脓肿患者,在超声定位引导下经皮肝穿刺,采取穿刺抽吸、置管引流的方法,进行脓液的抽吸、引流,以灭滴灵反复冲洗;同时给予静脉滴注抗生素、加强支持疗法等综合措施.结果 在超声引导下经皮肝穿刺抽吸或置管引流脓液后3天内体温逐步降至正常,脓腔缩小,穿刺后平均住院天数14.4天.结论 超声引导下经皮肝穿刺治疗肝脓肿,操作简便,疗效肯定,避免了传统的开腹手术,是临床首选的治疗方法.     

细菌性肝脓肿经皮肝穿刺置管引流术中的循证护理

目的探讨循证护理在超声引导下经皮肝穿刺置管引流术治疗细菌性肝脓肿的疗效。方法选取80例患者,按照随机数字表法分为对照组和实验组,每组40例。对照组给予常规护理,实验组在对照组基础上实施循证护理干预。比较2组住院情况及并发症发生率。结果 2组患者体温恢复时间比较,差异无统计学意义(P 0.05);实验组脓腔消失时间、住院时间短于对照组,并发症率低于对照组,差异有统计学意义(P 0.05)。结论细菌性脓肿患者在超声引导下经皮肝穿刺置管引流术治疗过程中实施循证护理,能缩短脓腔消失时间和住院时间,降低并发症发生率。     

超声引导下置管引流与穿刺抽吸在肝脓肿治疗中的比较

目的:比较超声引导下穿刺抽吸与置管引流在肝脓肿治疗中优劣。方法:33例置管引流与87例穿刺抽吸两组患者,术后比较体温及白细胞下降至正常的时间,平均住院时间以及并发症。两种方法均同时采用静脉内给抗生素治疗。结果:两组方法在疗效及安全性上无显著差异(包括体温及白细胞降至正常时间,平均住院时间以及并发症)。结论:超声引导下穿刺抽吸或置管引流在治疗肝脓肿的疗效与安全性均无显著差异。     

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.     

Ultrasonically guided percutaneous drainage of abdominal fluid collections: A long-term study of its therapeutic efficacy

Fifty patients underwent ultrasonically guided percutaneous drainage (US-GPD) either with needle aspiration or catheter drainage. The procedures resulted in 70% complete recovery, 20% partial success and 10% of failures. The same patients were followed with clinical examination and sonography for a mean time of 36.3 months (minimum follow-up: 12 months). During the follow up period, 10 relapses occurred and one patient, considered for surgery after partial percutaneous treatment of a pyogenic liver abscess, recovered completely under conservative treatment. An analysis of the factors potentially related to the recurrence was made. It was found that one-step needle aspiration of abdominal abscesses and percutaneous treatment of chronic pancreatic pseudocysts are more prone to relapses. We conclude that US-GPD is an efficacious therapy for abdominal fluid collections, but an adequate drainage technique and a careful selection of the patients is crucial to avoid the possibility of relapse.     

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.     

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.     

EMS标准通道经皮肾镜治疗肾皮质脓肿17例临床分析

目的探讨EMS标准通道经皮肾镜治疗肾皮质脓肿的疗效及安全性。方法 17例肾皮质脓肿患者,均行EMS标准通道经皮肾镜穿刺、抽吸、置管引流治疗。结果本组均一次置管成功,治愈率100%;手术时间18~30min;金黄色葡萄球菌感染14例,大肠杆菌感染3例;术后留置引流管5~7d;无出血、尿瘘及肝、脾、肠管损伤等严重并发症发生;随访3~48个月无复发。结论 EMS标准通道经皮肾镜治疗肾皮质脓肿安全、有效。     

Percutaneous drainage of pelvic abscesses: management of the tubo-ovarian abscess

Percutaneous drainage of 35 pelvic abscesses secondary to pelvic inflammatory salpingitis are reported. Two methods of drainage were used: simple aspiration and catheter drainage. The success rate of aspiration drainage was 94 per cent, while catheter drainage yielded a 77 per cent success rate. The differences between pelvic abscess drainage and other types of percutaneous drainage are presented. The role of percutaneous drainage in the treatment of pelvic inflammatory disease is also discussed.     

Sonographic appearances and percutaneous management of primary tuberculous liver abscess

Primary tuberculous liver abscesses are rare. We report on 3 patients who presented with a nonresolving abscess in the liver. Clinical presentation and sonographic findings in each case were nonspecific. A diagnosis of tuberculosis was established with microbiologic examination of pus in 2 cases and examination of an excised abscess wall in 1 case. Needle aspiration (1 patient) and short-term (72 hours) catheter drainage (1 patient) were unsuccessful, and surgical excision was required in these patients. In the third patient, continuous catheter drainage over 18 days resulted in cure, indicating that long-term catheter drainage with antituberculous chemotherapy may be a viable alternative to surgery in the management of primary tuberculous liver abscess.     

彩色多普勒超声引导下经皮穿刺留置中心静脉导管引流并反复抗生素冲洗治疗老年肺脓肿

目的探讨彩色多普勒超声引导下经皮穿刺留置中心静脉导管引流并反复抗生素冲洗治疗老年肺脓肿的治疗方法和临床应用价值。方法对58例老年肺脓肿患者进行了彩色多普勒超声引导经皮穿刺留置中心静脉导管引流并反复抗生素冲洗法治疗。结果所有患者均一次性穿刺成功,成功率100%,术后使用氯化钠和抗生素稀释后反复抽洗脓腔,直至脓液相对减小或闭合时,拔出引流导管,随访0.5～3年,56个肺脓肿治愈,治愈率96.6%,均未出现出血与气胸等并发症。结论彩色多普勒超声引导下经皮穿刺留置中心静脉导管引流并反复抗生素冲洗治疗老年肺脓肿,成功率和治愈率高,并发症少。