超声联合多层螺旋CT引导穿刺抽吸与置管引流对细菌性肝脓肿患者炎性反应的影响  

Effect of ultrasound combined with multi-slice spiral CT-guided puncture-aspiration or catheter drainage on inflammatory response in patients with bacterial liver abscess

作　　者：董达 徐斌 胡洁敏 海伟 DONG Da;XU Bin;HU Jie-min;HAI Wei(Department of Ultrasonography,Suzhou Ninth People's Hospital,Jiangsu 215000,China)

机构地区：[1]苏州市第九人民医院超声科,江苏215000

出　　处：《肝脏》2021年第3期312-315,共4页Chinese Hepatology

基　　金：院级科技计划项目(WS200814)。

摘　　要：目的观察超声联合多层螺旋CT引导穿刺抽吸与置管引流对细菌性肝脓肿患者炎性反应的影响。方法选择苏州市第九人民医院2017年2月至2019年8月期间收治的84例细菌性肝脓肿患者作为研究对象,全部患者手术的实施均在超声联合多层螺旋CT引导下进行,根据治疗方法的不同分为抽吸组与置管引流组,各42例。评估并比较两组治疗效果,分别于入院时、术后3 d、术后7 d,采集患者外周肘静脉血,处理后检测炎性反应相关指标[降钙素原(PCT)、C反应蛋白(CRP)]水平,术后记录各组并发症发生情况。结果等级资料秩和检验结果显示,抽吸组与置管引流组整体治疗效果比较差异无统计学意义(P>0.05);且卡方检验结果显示,两组患者治疗总有效率比较差异无统计学意义(P>0.05);术后3 d、术后7 d,两组PCT、CRP水平均较入院时降低(P<0.05);且治疗各时点,两组患者PCT、CRP水平比较差异无统计意义(P>0.05);两组术后均无严重并发症发生。结论在明确细菌性肝脓肿患者的适应症后,为其选择实施超声联合多螺旋CT引导穿刺引流术或抽吸术治疗,均能很好的减轻患者炎性反应,引流效果均较好,且无并发症发生,安全可靠。Objective To observe the effect of ultrasound combined with multi-slice spiral CT-guided punctureaspiration or catheter drainage on inflammatory response in patients with bacterial liver abscess.Methods 84 patients with bacterial liver abscess who admitted in the hospital from February 2017 to August 2019 were selected as subjects.All patients underwent ultrasound combined with multi-slice spiral CT-guided surgery,and they were divided into aspiration group and catheter drainage group according to the treatment methods,with42 cases in each group.The curative effects of two groups were evaluated and compared.On admission,after the 3 rd and 7 rd day after surgery,the peripheral elbow venous blood of patients was collected,and the inflammatory response indexes[procalcitonin(PCT),C-reactive protein(CRP)]were detected after processing.The postoperative complications in each group were recorded.Results The results of rank sum test of ranked data showed that there was no statistical difference in the overall curative effects between aspiration group and catheter drainage group(P>0.05).The results of chi-square test showed that there was no statistical difference in the total effective rate between the two groups(P>0.05).After surgery for 3 d and 7 d,the levels of PCT and CRP in two groups were lower than those on admission(P<0.05).There was no statistical difference in the levels of PCT and CRP between two groups at each time after surgery(P>0.05).There were no severe postoperative complications in both groups.Conclusion After clarifying the indications for patients with bacterial liver abscess,ultrasound combined with multi-slice spiral CT-guided puncture drainage or aspiration therapy could alleviate inflammatory response and achieve better drainage effects,and have no complications,which was safe and reliable.

关 键 词：细菌性肝脓肿 穿刺引流术 超声 多层螺旋CT 炎性反应 

分 类 号：R657.3[医药卫生—外科学]