早期手术治疗阑尾周围脓肿63例分析

目的 探讨阑尾周围脓肿早期手术的疗效。方法 对63例1990—2005年阑尾周围脓肿行早期阑尾切除，脓肿清除，肠粘连松解，回盲部修补和右半结肠切除术进行回顾性研究，分析其术中情况、手术方法、并发症以及治疗结果。结果 所有患者均在术后3周内痊愈出院，手术发生并发症10例，发生率15．87％。结论 阑尾周围脓肿早期手术切实可行。     

中西医结合治疗细菌性肝脓肿临床观察

目的：观察抗生素、厌氧治疗、局部穿刺引流合用中药“银鱼角消脓汤”治疗细菌性肝脓肿的疗效。方法：对临床诊断细菌性肝脓肿患者66例随机分为两组。治疗组44例用中西医结合治疗，对照组22例用单纯西医治疗。观察两组总有效率及体温复常、疼痛消失、血象复常、脓肿消失、住院时间五项临床指标。结果：治疗组总有效率95．5％，明显高于对照组的77．3％（P〈0．05），临床五项指标治疗组均优于对照组。结论：中西医结合治疗细菌性肝脓肿比单纯西医治疗更有效。     

Life-threatening pica: Liver abscess from perforating foreign body

A case is presented of a patient with a psychiatric illness and pica who developed a pyogenic liver abscess due to perforation of the duodenum by a pen. This report emphasizes the importance of ultrasound and computed tomography in making a rapid diagnosis. The relative superiority of ultrasound was revealed because an anaesthetic was not required for scanning, and in addition to the liver abscess, the precise location of the perforating foreign body was demonstrated.     

Prognostic nutritional index as outcome predictor in patients with iliopsoas abscess

Cases with iliopsoas abscess (IPA) in a single hospital-based cases were reviewed and compared with clinical profiles of published hospital-based IPA series. To verify usefulness of prognostic nutritional index (PNI) used to predict outcome and severity of IPA, this study was performed. This study consists of 2 parts: Study 1 – Case review of IPA series in a single hospital: 7 cases with IPA treated in a single hospital in sequential 5 years were collected (series 1) and their clinical profiles compared. Study 2 – Review of hospital-based literature: A search of the PubMed database from 1990 to the present was performed, using the Boolean expression ([Psoas OR iliopsoas] AND [abscess] AND [hospital-based]). Two hospital-based case series were collected. The clinical profiles of 2 series were compared with series 1 to draw predictive factors of outcome and deciding treatment modality, medical or surgical. Study 1 – Analyzing 7 IPA cases, average age was 76.7 years old (varying from 64 to 91) and the lifesaving rate was 86%. PNI < 45, calculated with serum albumin (Alb) and total lymphocyte count, and larger cumulative abscess volume (CAV) measured by computed tomography seem outcome predictors. Study 2 – Analyzing 2 hospital-based IPA series (series 2 and 3), series 2 reviewed isolated IPA cases without any comorbidities and series 3 reviewed IPA cases with cardiovascular disorders. Among 3 series including ours, series 1 showed oldest case and longer length of hospitalization. Series 3 showed the highest mortality among 3 because it collected IPA with cardiovascular comorbidities. PNI seems predictors of outcome and disease activity in patients with IPA and might indicate treated with surgical intervention.     

产气荚膜梭菌感染引起肝脓肿和严重溶血性贫血1例及文献复习

探讨糖尿病患者产气荚膜梭菌(Cp)感染导致肝脓肿、溶血性贫血的临床特点及诊疗经过,提高对此类患者的认识和诊治水平。分析某院2022年8月收治的1例Cp感染引起肝脓肿、溶血性贫血、血流感染、多脏器功能衰竭的糖尿病患者临床资料,结合相关文献进行回顾性分析。共检索到19篇外文文献,结合本研究1例,共纳入20例患者。男性、女性各10例,平均年龄70.7岁,合并糖尿病12例。患者临床表现缺乏特异性,所有患者均有不同程度的溶血性贫血。死亡17例(85.0%),从就诊到死亡平均时间23.84 h,其中14例(82.4%)患者在明确病原菌诊断前已死亡,11例(64.7%)患者在入院≤8 h因抢救无效死亡;存活患者仅3例,均在疾病早期得到病原学结果,2例患者早期行肝脓肿穿刺引流术,另1例患者治疗过程中肝脓肿自行破溃至肝包膜下,肿块缩小。Cp感染肝脓肿合并溶血性贫血进展迅速,早期病死率极高,故早期诊断十分重要。怀疑Cp感染时,应立即行穿刺液/血液革兰染色,或经宏基因组二代测序(mNGS)等检测手段明确病原诊断,以期通过早期调整敏感抗菌药物和清除感染病灶改变患者生存结局。     

中医旷置疗法在马蹄型肛周脓肿手术中应用研究进展

目的：分析对马蹄型肛周脓肿手术中应用中医旷置法的临床疗效及价值,并对近几年的相关研究文献进行总结.方法：选取2012年3月-2014年1月在我院接受治疗的低位马蹄型肛周脓肿患者60例为研究对象,随机将上述选取对象分成两组,对照组采取多切口隧道引流术,观察组采取多切口隧道浮线术进行治疗,观察和对比两组患者在疼痛持续时间、创面愈合时间、肛门功能恢复、治疗效果等指标上的差异性.结果：观察组30例患者术后疼痛持续时间和创面愈合时间均明显短于对照组,两组间上述两指标对比差异有统计学意义（P〈0.05）;而两组患者在治疗效果、肛门功能恢复情况、创面瘢痕面积等指标对比差异并不明显,无统计学意义（P〉0.05）.结论：对于马蹄型肛周脓肿患者,临床上可将多种中医旷置法有机的组合起来,针对肛周脓肿类型,制定相应的治疗方案,能最大程度的清除病变组织,减少创伤和术后痛苦,缩短恢复时间,这对改善患者预后,提升生活质量有重要意义,值得探索和研究.     

苦柏洗剂联合马应龙痔疮膏治疗肛周脓肿术后创面愈合临床观察

目的 观察苦柏洗剂联合马应龙痔疮膏治疗肛周脓肿术后创面愈合的临床疗效.方法 将128例行肛周脓肿一次性根治术患者按照随机数字表法分为对照组和研究组,各64例.对照组用盐酸头孢替安注射液静脉滴注,配以高锰酸钾1:5000熏洗坐浴创面治疗;研究组采用苦柏洗剂联合马应龙痔疮膏治疗.比较2组患者临床疗效、术后创面疼痛情况、肛缘...     

微创挂线术治疗直肠肛周脓肿的效果

〔摘 要〕 目的：评价直肠肛周脓肿患者运用微创挂线术治疗的效果。方法：选取 2019 年 1 月至 2020 年 1 月期间 安阳市中医院接收治疗的直肠肛周脓肿患者 50 例为研究对象,根据不同治疗方式分为对照组和观察组,各 25 例。对 照组接受一期根治术治疗,观察组展开微创挂线术治疗,术后比较两组患者手术指标、临床疗效、疼痛程度数字评估 量表（NRS）评分及日常生活能力评定量表（ADL）评分等。结果：观察组患者的手术时长、住院天数、手术出血量、 创面愈合时间等指标均优于对照组,差异具有统计学意义（P ＜ 0.05）。在临床疗效方面,观察组患者的总有效率明 显更高于对照组,差异具有统计学意义（P ＜ 0.05）。术后,两组患者的 NRS 评分均下降,ADL 评分均上升,且观 察组 NRS 评分低于对照组,ADL 评分高于对照组,差异均具有统计学意义（P ＜ 0.05）。结论：直肠肛周脓肿患者 运用微创挂线术治疗,相对于一期根治术可以缩短治疗时间和患者康复时间,且能更有效地提高患者的日常生活能力, 降低术后疼痛。