超声造影引导经皮置管引流治疗不典型肝脓肿的应用价值  

Clinical application value of percutaneous catheter drainage guided by contrast-enhanced ultrasound in the treatment of atypical liver abscess

作　　者：吴婷婷 弭琦伟 方超[1] WU Ting-ting;MI Qi-wei;FANG Chao(Department of Ultrasound,Shanghai Xuhui Central Hospital,Shanghai 200031,China)

机构地区：[1]上海市徐汇区中心医院超声医学科,上海200031

出　　处：《中国临床医学影像杂志》2021年第8期536-539,共4页Journal of China Clinic Medical Imaging

基　　金：上海市自然科学基金(19ZR1450700)。

摘　　要：目的:探讨常规超声引导与超声造影引导经皮穿刺置管引流术在不典型肝脓肿治疗中的临床效果。方法:选择2016年2月—2021年4月于我院就诊的49例不典型肝脓肿患者,随机分成实验组(超声造影引导)25例和对照组(常规超声引导)24例。观察比较两组置管时机、置管引流有效率、临床症状消失所需时间、脓腔缩小90%以上所需时间、持续引流时间、住院时间、治疗总费用等。结果:常规超声引导置管引流有效率37.5%(9/24),超声造影引导置管引流有效率84%(21/25),实验组的置管时机明显早于对照组,实验组的临床症状消失所需时间、脓腔缩小90%以上所需时间、持续引流时间、住院时间均显著短于对照组,差异具有显著统计学意义(P<0.01),治疗费用低于对照组,差异具有统计学意义(P<0.05),两组患者都未见并发症。结论:超声造影能准确评估不典型肝脓肿液化坏死区域,超声造影引导经皮穿刺置管引流治疗不典型肝脓肿较常规超声引导更有效,值得临床推广应用。Objective:To explore and study the effect of conventional ultrasound and contrast-enhanced ultrasound(CEUS)guided percutaneous catheter drainage for the treatment of atypical liver abscess.Methods:Forty-nine patients with atypical liver abscess admitted to our hospital from February 2016 to April 2021 were randomly divided into experimental group(CEUS guided)and control group(conventional ultrasound guided),with 25 cases in the experimental group and 24 cases in the control group.The timing of catheter placement,the efficiency of percutaneous catheter drainage,the time required for clinical symptoms to disappear,the time required for the abscess cavity to reduce more than 90%,the duration of continuous drainage,the length of hospital stay and the total cost of treatment were compared between the two groups.Results:The effective rate of conventional ultrasound-guided drainage was 37.5%(9/24)and the effective rate of CEUS guided drainage was84%(21/25).The timing of catheter placement in experimental group was significantly earlier than that in control group.Among the time required for clinical symptoms to disappear,the time required for the abscess cavity to reduce more than 90%,the duration of continuous drainage and the length of hospital stay in the experimental group were significantly shorter than those in the control group,which was statistically significant(P<0.01).The cost of treatment of the experimental group was lower than that of the control group(P<0.05).No complications were seen in either group.Conclusion:CEUS can accurately assess the liquefactive necrosis area of atypical liver abscess,and CEUS guided percutaneous catheter drainage is more effective than conventional ultrasound-guided catheter drainage,which is worthy of clinical application.

关 键 词：肝脓肿 超声检查 介入性 

分 类 号：R575.4[医药卫生—消化系统] R445.1[医药卫生—内科学]