分析肝脓肿介入治疗住院时间的影响因素

目的分析肝脓肿行经皮穿刺置管引流术的影响因素。 方法选择DSA引导下经皮肝穿刺置管引流并采用不同冲洗液冲洗脓腔治疗肝脓肿116例，进行资料分析，患者平均（59.98±16.73）岁，其中男性76例，女性40例。既往有糖尿病49例，无糖尿病67例；脓肿单发者48例，多发者68例；住院期间有并发症者104例，无并发症的12例。对穿刺液经行细菌培养，大肠杆菌阳性者20例，肺炎克雷白杆菌52例，其他致病菌8例，培养阴性36例。按冲洗液不同分为两组：A组，置管后先使用甲硝唑注射液冲洗，细菌培养及药敏结果明确后改用含敏感抗生素液体冲洗脓腔，共68例；B组，置管后全程使用甲硝唑冲洗，共48例。 结果116例肝脓肿患者治疗有效率100%。统计分析结果显示性别、有无并发症对住院时间影响的差异无统计学意义；年龄与住院时间无相关关系；糖尿病、脓肿数目及不同冲洗方法对住院时间的影响差异有统计学意义。 结论DSA引导下经皮肝穿刺置管引流冲洗治疗肝脓肿疗效确切，糖尿病是影响住院时间的重要因素；多发肝脓肿的住院时间较单发的明显延长；采用敏感抗生素溶液冲洗肝脓肿效果更显著。

Analysis of prognostic impact factors of liver abscess with interventional treatment

ObjectiveTo analyze the prognostic factors of percutaneous catheter drainage in the treatment of liver abscess. MethodsA total of 116 patients with liver abscess were treated by DSA guided percutaneous liver puncture and drainage under guidance. The average age was 59.98±16.73 years old, including 76 males and 40 females. According to past history, 49 cases of diabetes, nondiabetes in 67 cases; 48 cases of solitary abscess, 68 cases of multiple; 104 cases with complications during hospitalization, 12 cases without complication. From the puncture fluid bacterial culture results of view, Escherichia coli positive in 20 cases, 52 cases of pneumonia Cray bacteria and other pathogens in 8 cases, 36 cases of culture negative. According to the washing liquid is divided into 2 groups, A group: after placing the drainage tube, the liver abscess was washed with metronidazole injection, bacterial culture and drug sensitivity were made clear to the use of sensitive antibiotics injection to flush the pus cavity, a total of 68 cases; group B: 48 cases were washed with metronidazole after setting the tube. ResultsThe effective rate of 116 cases of liver abscess was 100%. The statistical analysis showed that there was no significant difference in the effect of sex, or without complications on the length of hospital stay. The influence of the number of diabetes, the number of abscess and the different irrigation methods on the length of hospital stay was statistically significant. ConclusionsDSA guided percutaneous liver puncture and drainage of the treatment of liver abscess is effective, Diabetes is an important factor affecting the length of hospital stay. The length of hospital stay was significantly increased in multiple liver abscess. The effect of the use of sensitive antibiotics in the liver abscess was more obvious.