超声引导经皮穿刺置管引流治疗腹腔脓肿

目的 探讨超声引导下经皮穿刺置管引流(PCD)治疗腹腔脓肿的技术.方法 超声引导下对91例140次腹腔脓肿患者施行PCD治疗.结果 91例140次PCD治疗中除1次无法置管外,余均能一次置管成功,一次成功率达99.29%.其中16例同时置入两根管,21例先后置入两根管,6例先后置入三根管,共140次.成功置管的90例患者均于引流后48h内症状缓解,其中61例于12h内明显缓解.各小组引流治愈率分别为:膈下脓肿88.89%、胆囊床脓肿100%、胆漏87.50%、胰周脓肿93.10%、肠间脓肿75%、盆腔脓肿92.31%;本组总引流治愈率为86.81%.结论 PCD治疗腹腔脓肿能迅速解除患者的严重症状,具有避免因紧急手术或再次手术引起的并发症优点,充分发挥了超声微创技术创伤少、灵活、准确的优势,明显降低死亡率.

Clinical efficacy of ultrasound guided percutaneous catheter drainage for the treatment of abdominal abscesses

Objective To explore the techniques of ultrasound guided percutaneous catheter drainage(PCD)for the treatment of abdominal abscesses.Methods Ninety-one cases of abdominal abscesses were performed 140 times of ultrasound guided PCD.Results All of the 91 patients with 140 times of PCD could be performed successfully in the first time except one case of fulminating severe pancreatitis due to abnormal curvature of the guide wire at the time of insertion because of incomplete colliquation,and the first time success rate was 99.29%.Among the 140 times of PCD,16 cases were inserted with 2 catheters at the same time,21 cases were inserted with 2 catheters at two times,and 6 cases were inserted 3 catheters one after another.Ninety patients who had been drained successfully showed symptomatic relief within 48 hours,and 61 cases relived within 12 hours.The cure rates of drainage in each group were 88.98% in subdiaphragmatic abscess,100% in abscess of fossa of gallbladder,87.5% in bile leakage,93.1% in parapancreatic abscess,75% in interbowel abscess and 92.31% in pelvic abscess.The total cure rate was 86.81%.Conclusion Ultrasound guided PCD for the treatment of abdominal abscess can relieve the severe symptoms of such patients.It has the merits of avoiding the complications of emergent operation or another operation.It also can exert the advantages of microinvasive,convenience,agility and accurate of ultrasound guided technology,reduce mortality rate of such patients.Its prominent effects are worthy of further application.