超声引导下经皮腹腔穿刺在小儿阑尾周围脓肿中的应用价值  

Application value of ultrasound-guided percutaneous peritoneal puncture in children with peri-appendiceal abscess

作　　者：裴勖斌[1] 张琪 杨礼[1] 张延刚[1] 刘百灵[1] PEI Xubin;ZHANG Qi;YANG Li;ZHANG Yangang;LIU Bailing(Ultrasound Department,Xi'an Children's Hospital,Xi'an 710003,China)

机构地区：[1]西安市儿童医院超声科,陕西西安710003

出　　处：《临床医学研究与实践》2021年第25期103-105,共3页Clinical Research and Practice

摘　　要：目的探讨超声引导下经皮腹腔穿刺在小儿阑尾周围脓肿中的应用价值。方法选取2016年1月至2018年1月西安市儿童医院外科收治的阑尾周围脓肿患儿132例,均行超声引导下的经皮腹腔穿刺治疗,并根据脓肿大小选择不同的治疗方法,对于直径<3 cm的脓肿行穿刺抽吸治疗,设为穿刺抽吸组,对于直径3~5cm的脓肿行穿刺抽吸合并甲硝唑冲洗治疗,设为穿刺抽吸合并甲硝唑冲洗组,对于直径>5 cm的脓肿予以穿刺置管引流合并甲硝唑冲洗治疗,设为置管引流合并甲硝唑冲洗组。随访观察治疗后2周患儿的病情及脓肿大小变化情况。结果刺抽吸组48例(36.4%)、穿刺抽吸合并甲硝唑冲洗组47例(35.6%)、置管引流合并甲硝唑冲洗组37例(28.0%)手术均一次成功,无明显并发症。所有患儿术后第1天、第3天及第1周治疗有效率分别为31.8%、92.4%及97.7%。术后2周复查所有患儿均无明显不适,复查超声示脓肿基本消失,无复发患儿。术后第1周,三组的治疗有效率及治愈率均无显著差异(P>0.05)。结论超声引导下经皮腹腔穿刺治疗小儿阑尾周围脓肿安全、有效、微创、方便、操作简单,值得基层医院推广。Objective To explore the application value of ultrasound-guided percutaneous peritoneal puncture in children with peri-appendiceal abscess.Methods A total of 132 children with peri-appendiceal abscess admitted in the surgery department of Xi'an children's hospital from January 2016 to January 2018 were selected.All of them received ultrasound-guided percutaneous peritoneal puncture therapy,and different treatment methods were selected according to the size of the abscess.The abscesses with a diameter of<3 cm were treated with puncture aspiration,seted as puncture aspiration group,the abscesses with a diameter of 3-5 cm were treated with puncture aspiration combined with metronidazole irrigation,seted as puncture aspiration combined with metronidazole irrigation group,and the abscesses with a diameter of>5 cm were treated with puncture tube drainage combined with metronidazole irrigation,seted as puncture tube drainage combined with metronidazole irrigation group.The children were followed up to observe the condition and the changes in the size of the abscess at 2 weeks after treatment.Results The operation of 48 cases(36.4%)in the puncture aspiration group,47 cases(35.6%)in the puncture aspiration combined with metronidazole irrigation group and 37 cases(28.0%)in the puncture tube drainage combined with metronidazole irrigation group were all successful at one time,and there were no obvious complications.The effective rates of treatment of all children on the 1st day,3rd day and 1st week after operation were 31.8%,92.4%and 97.7%,respectively.Two weeks after operation,all children had no obvious discomfort,and the reexamination ultrasound showed that the abscess basically disappeared and there was no recurrence.In the first week after operation,there were no significant differences in effective rate of treatment and cure rate among the three groups(P>0.05).Conclusion Ultrasound-guided percutaneous peritoneal puncture in the treatment of children with peri-appendiceal abscess is safe,effective,minimally invasive,co

关 键 词：阑尾周围脓肿 超声 经皮腹腔穿刺 小儿 

分 类 号：R574.61[医药卫生—消化系统] R445.1[医药卫生—内科学]