超声引导下经皮穿刺抽吸或置管治疗细菌性肝脓肿疗效比较  

Sonographically guided percutaneous needle aspiration versus catheter drainage in management of pyogenic liver abscess

作　　者：王军 孙松 

机构地区：[1]北京市昌平区中医医院普外科,102200

出　　处：《武警医学》2014年第11期1118-1120,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的比较超声引导下穿刺抽吸或置管引流对细菌性肝脓肿的疗效。方法回顾性分析我院1994-01至2013-01收治的经超声引导下穿刺抽吸或置管引流的细菌性肝脓肿96例,分别比较两组患者之间的治疗成功率、并发症率、病死率及住院时间。结果分别有42例及54例行穿刺抽吸及置管引流治疗,两组间并发症率(4.8%vs 5.6%,P=1.00)、病死率(2.3%vs 1.9%,P=1.00)及住院时间[(19.1±12.1)d vs(21.6±12.5)d,P=0.44]差异无统计学意义。置管引流组治疗成功率显著高于抽吸组(61.9%vs 92.6%,P=0.00),但对于脓腔直径≤6 cm者,治疗成功率无明显区别(91.0%vs 96.7%,P=0.57)。结论超声引导下经皮穿刺置管引流治疗肝脓肿优于穿刺抽吸,对于直径≤6 cm者,穿刺抽吸是可选择的替代手段。Objective To compare percutaneous needle aspiration（ PNA） and percutaneous catheter drainage（ PCD） in the management of liver abscess. Methods A retrospective study during the last twenty years（ 01 /1989-01 /2008） were performed. 96 patients with pyogenic liver abscess were treated by PNA or PCD. Patient demographics,treatment outcome,duration of hospital stay,and morbidity and were analyzed. Results There were 42 and 54 patients with aspiration and catheter drainage treatment; complication rates in the two groups were（ 4. 8% vs 5. 6%,P = 1. 00）,mortality（ 2. 3% vs 1. 9%,P = 1. 00） and length of hospital stay（ 19. 1 ± 12. 1d vs 21. 6 ± 12. 5 d,P = 0. 44） without significant difference. In catheter drainage treatment group,the success rate was significantly higher than in aspiration group（ 61. 9% vs 92. 6%,P = 0. 00）,but the diameter of ≤6 cm abscess and treatment success had no significant difference（ 91. 0% vs 96. 7%,P = 0. 57）. Conclusions PCD is more effective than PNA in the management of pyogenic liver abscess. PNA can be used as a valid alternative for simple abscesses 6cm in diameter or smaller.

关 键 词：细菌性肝脓肿 超声引导 经皮穿刺抽吸或置管 治疗 比较 

分 类 号：R575.4[医药卫生—消化系统]