超声引导下肝脓肿经皮穿刺针单纯抽吸与置管引流疗效比较

目的 对比超声引导下肝脓肿经皮穿刺针(PTC)抽吸与超声引导下置管引流的疗效。 方法 2014年1月—2015年12月选取在湖州市中心医院超声科就诊的40例细菌性肝脓肿患者，采用随机数字表将40例细菌性肝脓肿患者分为2组，其中A组患者(20例)在超声引导下用PTC针行单纯抽吸术，B组患者(20例)在超声引导下行置管引流术。观察2组一次性治愈率、体温恢复正常时间、疼痛减弱时间、脓肿腔消失时间及住院治疗时间，随访有无复发及并发症发生情况等。 结果 B组20例患者治愈，有效率为100%；A组13例患者一次穿刺治愈，有效率为65%，4例2～5 d后行第2次穿刺后治愈，其余3例在2次穿刺后仍有较大脓腔，行置管引流术后治愈。2组患者的有效率比较差异有统计学意义(P＜0.05)。A组体温恢复正常时间、疼痛减弱时间、脓肿消失时间及住院时间分别为(3.0±0.6) d、(2.5±0.6) d、(12.5±3.5) d、(15.6±4.0) d，均长于B组的(2.0±0.5) d、(1.2±0.5) d、(7.2±2.0) d、(10.3±3.0) d，差异有统计学意义(P＜0.05)。A组并发症发生率为40.0%(8/20)，B组并发症发生率为5.0%(1/20)，2组并发症比较差异有统计学意义(χ2=5.161，P＜0.05)。 结论 细菌性肝脓肿经超声引导下置管引流管治疗，能有效提高患者治疗效果，减轻患者疼痛感，缩短患者治疗时间，效果显著，值得推广。 

A comparison of clinical curative effect between ultrasound-guided percutaneous transhepatic cholangiography needle suction and catheter drainage for liver abscess

Objective To compare the clinical efficacy of ultrasound-guided percutaneous transhepatic cholangiography(PTC) needle suction and catheter drainage for liver abscess. Methods A total of 40 cases of bacterial liver abscess in our hospital were randomly divided into group A and B with 20 cases in each group.The patients in the group A were treated with simple suction technique by using PTC needle under the guide of ultrasound;while the patients in the group B were treated with Ultrasound-guided catheter drainage.The one-time recovery rate,time for body temperature recovery,pain remission and abscess cavity disappeared,and duration of hospital stays;the follow-up was carried out to observe the incidence of recurrence and complications. Results All 20 cases in group B were one-time cured with an effective rate of 100%;however,in the group A,only 13 cases in the first attempt were cured with a rate of 65%;4 cases recovered by the second attempt in 2 to 5 days after the first attempt,the other 3 cases remained larger vomica after the second puncture underwent catheter drainage.The difference of clinical effectiveness between the two groups was significant(P<0.05);The time for body temperature recovery,pain remission,abscess cavity disappeared and hospital stay in group A was(3.0±0.6)d,(2.5±0.6)d,(12.5±3.5)d and(15.6±4.0)d,respectively,which were longer than those of group B(2.0±0.5) d,(1.2±0.5) d,(7.2±2.0) d and(10.3±3.0) d,respectively],the difference was significant(P<0.05);The incidence of complications of group A was 40%,which was higher than that of the group B(5.0%),the difference was significant(χ2=5.161,P<0.05). Conclusion The ultrasound-guided catheter drainage for liver abscess can effectively improve the curative efficacy,relieve the pains of patients,shorten the treatment time,which is worth of clinical promotion.