超声定位穿刺置管引流治疗化脓性肝脓肿的临床研究  

Observation of the curative effect of ultrasound positioning puncture catheter drainage in the treatment of purulent liver abscess

作　　者：吕爱娟 孙立如 杨欢 LV Ai-juan;SUN Li-ru;YANG Huan(Ultrasonography department,Tangshan hospital of traditional Chinese medicine,Tangshan,Hebei,063000,China;不详)

机构地区：[1]唐山市中医医院超声科,河北唐山063000 [2]唐山市中医医院泌尿外科

出　　处：《中西医结合肝病杂志》2023年第3期230-233,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河北省中医药科学技术支撑项目(No.20192027)。

摘　　要：目的:探讨超声定位穿刺置管引流治疗化脓性肝脓肿(PLA)的临床疗效。方法:2019年12月至2020年12月唐山市中医医院收治的化脓性肝脓肿患者61例,按照治疗方法的不同分为两组:抽吸排脓组(29例,行超声定位穿刺抽吸治疗)、置管排脓组(32例,行超声定位经皮穿刺置管引流治疗)。比较治疗前后两组患者的实验室指标,比较致病菌培养结果、疗效结果以及手术相关指标。结果:置管排脓组患者的肝功能指标ALT、AST、Alb、ALP、CRP、WBC、NEUT%、TNF-α、IL-6、IL-8水平以及总有效率、手术时间、脓腔消失时间、体温恢复至正常时间、住院时间、术后并发症发生率均优于抽吸排脓组(均P<0.05),而致病菌培养结果与抽吸排脓组相比,差异无统计学意义(P>0.05)。结论:对于老年人、感染较重、合并严重内科疾病、不能耐受手术者以及脓腔直径为3~8 cm的PLA患者应用超声定位经皮穿刺置管引流进行治疗具有显著优势,建议作为首选治疗方法。Objective:To investigate the clinical efficacy of ultrasound positioning puncture and flushing combined with metronidazole in the treatment of suppurative liver abscess(PLA).Methods:A retrospective analysis of 61 patients with purulent liver abscesses admitted to Tangshan hospital of traditional Chinese medicine from December 2019 to December 2020 was divided into two groups according to the different treatment methods: aspiration pus discharge group(29 cases, ultrasound positioning puncture and aspiration), catheter drainage group(32 cases, ultrasound positioning percutaneous catheter drainage treatment). The four aspects of the two groups: laboratory indicators, pathogenic bacteria culture results, curative effect results, and surgery-related indicators for comparison. Results:T Laboratory indicators ALT, AST, ALB, ALP, CRP, WBC, NEUT%, TNF-α, IL-6, IL-8 levels in the catheter drainage group and the total effective rate of treatment, operation time, abscess disappearance time, body temperature. The recovery to normal time, hospitalization time, and postoperative complication rate were all better than those in the aspiration pus discharge group(P<0.05), while the results of pathogenic bacteria culture were not significantly different from those in the aspiration pus discharge group(P>0.05). Conclusion:For the elderly, with severe infections, serious medical diseases, intolerable surgery, and the diameter of the abscess cavity is three~eight cm, the application of ultrasonic positioning percutaneous puncture catheter drainage for treatment has significant advantages, and it is recommended as the first choice of treatment.

关 键 词：化脓性肝脓肿 超声定位 充分引流 冲洗 

分 类 号：R575.4[医药卫生—消化系统]