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  

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

作　　者：陈文显[1] 胡新娥[1] 韩运生[1] 熊伟律[1] 徐华军[1] 莫清清[1] 

机构地区：[1]湖州市中心医院超声科,浙江湖州313000

出　　处：《中华全科医学》2016年第9期1547-1549,共3页Chinese Journal of General Practice

摘　　要：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。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 trea- ted 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 （X2 = 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.

关 键 词：超声引导 细菌性肝脓肿 经皮穿刺针 置管引流术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.4[医药卫生—诊断学]