超声引导下穿刺置管治疗肝脓肿的临床效果回顾分析

目的 回顾分析介入置管引流治疗肝脓肿的效果及注意事项。 方法 以我院超声科自 2015 年 9 月至2019 年 9 月采用经皮穿刺置管治疗肝脓肿 49 例为研究对象,脓腔均经穿刺置管引流、并行脓腔冲洗、注药治疗、并根据药敏试验进行抗感染治疗。 结果 本研究 49 例患者均穿刺成功。 术后白细胞和中性粒细胞百分比均较术前明显减低(P 均<0. 05)。 术后及出院时 49 例患者脓肿直径明显小于术前,差异均有统计学意义( P均<0. 05);术后 25例患者体温 3 d 内恢复正常,16 例患者体温 3~ 7 d 内恢复正常,8 例患者体温超过 7 d 恢复正常。 患者均能较好耐受穿刺置管治疗,置管引流时间为 3~ 28 d,平均 13. 5 d,术中及术后未出现胆漏、感染及气胸等并发症,且均无复发迹象。 结论 超声引导下经皮穿刺置管引流治疗肝脓肿已逐渐取代大剂量药物治疗或手术治疗,且临床疗效可靠、并发症少,在临床治疗肝脓肿方法中优势明显。

Clinical effect of ultrasound-guided puncture and catheterization in the treatment of liver abscess

Objective To analyze the advantages and precautions of interventional drainage in the treatment of liver abscess. Methods From September 2015 to September 2019, 49 cases of liver abscess were treated by percutaneous puncture and catheterization in the ultrasound department of our hospital. The purulent cavity was treated by puncture and catheterization drainage, concurrent purulent cavity washing, drug injection and anti infection treatment according to drug sensitivity test. Results In this study, 49 patients were successfully punctured. The percentage of leukocytes and neutrophils decreased significantly(P<0. 05). The diameter of abscess was significantly smaller than that before operation( P< 0. 05). The body temperature of 25 patients returned to normal within 3 days, 16 patients returned to normal within 3~ 7 days, and 8 patients returned to normal after 7 days. All the patients could tolerate the treatment of catheterization, the drainage time was 3~ 28 days, average 13. 5 days, no complications such as bile leakage, infection and pneumothorax occurred during and after operation, and there was no recurrence. Conclusion Ultrasound-guided percutaneous drainage of liver abscess has gradually replaced the treatment of high-dose drugs or surgery, and the clinical effect is reliable, less complications, which has obvious advantages in clinical treatment of liver abscess.