改成熟型肝脓肿引流术为清除术的25例报告

目的:探讨以肝脓肿清除术取代传统肝脓肿引流术的可能性和方法。方法:对25例细菌性肝脓肿病人进行回顾性分析;22例采用冲洗、烧灼、加网膜填塞的方法(即“冲、烧、填”法),对另3例肝慢性坚壁脓肿(其中1例合并经久不愈的窦道)施行肝切除,从而达到完全清除脓肿组织的目的。结果:22例冲、烧、填法治疗的病人手术一次成功,不置引流物;术后7～9d出院,无一例切口感染;随访1～12年,无任何后遗症。3例肝切除者也获满意疗效。结论:肝脓肿清除术与传统引流术相比,具有治疗全过程时间短、费用低、疗效好及并发症少的优点,值得推广应用。

Complete clearance of liver abscess instead of traditional drainage in the treatment of bacterial liver abscess (A report of 25 cases)

Objective To evaluate the feasibility of complete clearance of liver abscess, instead of the traditional surgical drainage precedure in the treatment of bacterial liver abscess. Methods The clinical data of 25 cases of bacterial hepatic abscess were analyzed retrospectively. Twenty-two of the cases were treated by flushing the cavity with hydrogen peroxide and a mixture of metronidazole and kanamycin, burning the abscess wall with 5% iodine tincture, and finally filled up the cavity with greater omentum; in 3 other cases with chronic thick wall partial hepatic resection was performed. Results The 22 patients submitted to the above-mentioned clearance procedure without any drainage left the hospital for 7 to 9 days after operation,they were followed up for 1 to 12 years, with no postoperative complication(s) found. Conclusions Compared with the traditional drainage of liver abscess, the clearance procedure is safer and more effective, with faster recovery, and less complications. The complete clearance procedure is to be recommended for the treatment of bacterial hepatic abscess.