超声介入治疗细菌性肝脓肿的两种方法疗效比较

 目的 对比研究超声引导下经皮肝穿刺细针抽吸术与置管引流术治疗细菌性肝脓肿的疗效。方法 细菌性肝脓肿98例，其中直径≥5 cm 46例，直径＜5 cm 52例。对以上两种大小的脓肿，分别采取超声引导下经皮肝穿刺细针抽吸术和置管引流术两种方法治疗，比较两种方法治疗后脓肿消失时间、患者住院时间、血象、体温恢复正常时间等。结果 直径≥5 cm肝脓肿，置管引流术组在住院天数、脓腔消失时间等方面优于细针抽吸术组（P＜0.05），在术后血象、体温恢复正常时间方面两种方法无统计学差异（P>0.05）。直径＜5 cm肝脓肿，两种方法在住院天数、脓腔消失时间、术后血象、体温恢复正常时间方面无统计学差异（P>0.05）。结论 对于直径≥5 cm、直径＜5 cm的细菌性肝脓肿，应分别首选超声引导下经皮肝穿刺置管引流术、细针抽吸术。

Comparing of the two methods of ultrasound guided different interventional therapy in treatment of bacterial liver abscess

Objective To study the different therapeutic effect of ultrasound guided percutaneous needle aspiration and percutaneous catheter drainage on bacterial liver abscess. Methods 98 patients with bacterial liver abscess were recruited. Of 46 patients with abscess above five centimeters in diameter, 21 were treated by needle aspiration and 25 by percutaneous catheter drainage. Of 52 patients with abscess under five centimeters in diameter, 30 were treated by needle aspiration and 22 by percutaneous catheter drainage. The time of vomica extinction, the hospital day and the time of hemogram and body temperature being normal of the two methods after operation were compared. Results Percutaneous catheter drainage was superior to needle aspiration in the hospital day and the time of vomica elimination patients with abscess above five centimeters in diameter（P＜ 0.05）, but similar to needle aspiration in patients with abscess under five centimeters in diameter（P>0.05）. The differences of the two methods were not statistically significant in the recovery time of hemogram and body temperature for all cases, and in hospital day and the time of vomica elimination for patients with abscess under five centimeters in diameter（P>0.05）. Conclusions Ultrasound guided percutaneous catheter drainage is the first choice treatment for bacterial liver abscess above five centimeters in diameter, and needle aspiration is the first choice treatment for that under five centimeters in diameter.