CT引导下经皮穿刺置管引流术治疗单房颈深部脓肿的疗效分析  

Efficacy and safety of CT-guided percutaneous catheter drainage in treatment of uniloculated deep neck abscesses

作　　者：余爵波[1] 程泽星[1] 练状[1] 魏毅玲[1] 赵明俊[1] 肖路[1] 

机构地区：[1]江苏省扬州市第一人民医院耳鼻咽喉头颈外科,225009

出　　处：《中华全科医师杂志》2017年第2期128-131,共4页Chinese Journal of General Practitioners

摘　　要：回顾性分析我院2005年1月至2015年6月23例抗感染治疗失败而行CT引导下经皮穿刺置管引流术（PCD）治疗的单房颈深部脓肿（UDNA）患者的临床资料.所有患者均采用套管穿刺法进行置管,PCD治疗失败则立即行切开引流.其中19例（83％）脓腔均被完全吸收,3例（13％）因并发多房感染而行切开引流后治愈,1例（4％）带管出院后死于尿毒症.所有患者均留置1根引流管.1例术后出现组织内积气.技术成功率及临床治愈率分别为96％ （22/23）和83％（19/23）.所有患者留院观察并CT随访.穿刺过程中无死亡病例.提示PCD治疗安全、高效,费用低,可替代开放性手术引流治疗药物治疗无效的单房颈深部脓肿.Twenty-three patients with uniloculated deep neck abscesses （UDNA）,in whom the antibiotic therapy failed and CT-guided percutaneous catheter drainage （PCD） was performed from January 2005 to June 2015,were included in the study.Catheter placement was carried out using Trocar technique in all cases.Open surgical drainage was performed when PCD procedures failed.The abscess was completely drained and open surgical drainage was avoided in 19 cases （83%）;the surgical drainage was performed because of muhiple internal septation in 3 （13%） case,and 1 （4%） case died from uremia.In this series the technical success rate and clinical success rate of PCD were 96% （22/23） and 83% （19/23）,respectively.All patients were followed-up by CT scan.No other complications and no mortality occurred during the procedure,while postoperative pneumatosis developed in 1 case.CT-guided PDC is a safe and highly effective low-cost procedure for the treatment of patients with UDNA who failed medical therapy,it may be considered as an alternative to open surgery.

关 键 词：脓肿 颈深部 糖尿病 引流 CT引导 

分 类 号：R653[医药卫生—外科学]