介入超声在肝脓肿治疗方面的应用价值.PDFVIP

Team report 5     Patience  介入超声在肝脓肿治疗方面的应用价值 尹国涛 陈琰 高盼 武聪颖 王娜 ABSTRACT Objective ： To determine the advantage and limitation of percutaneous aspiration of hepatic abscess with ultrasound guidance Method ： Thirty-five patients with hepatic abscess were treated with percutaneous aspiration guided with ultrasound. And meanwhile, some cases were treated with antibiotic infusion, bacteria culture and drug sensitivity test were performed. Results ： All the patients were successfully punctured and the pathogens were observed in 18 cases, except 1 case complicating hepatic malignant tumor was treated with operation later. Conclusion ： The method of percutaneous aspiration of hepatic abscess with ultrasound guidance, which is safe, effective and has little complication, may play an important role in the treatment of hepatic abscess. While complicating other sort of disease, especially hepatic malignant tumor, the procedure should be carefully performed. KEY WORDS Ultrasonography, interventional; Hepatic abscess; Therapy 前言 （INTRODUCTION ）： 肝脓肿是临床上较为常见的病变，根据不同的致病微生物可将其分为三种类 型；其中细菌性肝脓肿常为多种细菌所致的混合感染，约占肝脓肿的 80% ；阿米 巴性肝脓肿约占 10% ；真菌性肝脓肿低于 10%。若不积极治疗，肝脓肿的死亡率 较高。肝脓肿的传统治疗方法是大剂量的抗生素治疗和外科手术引流。但内科方 法治疗，治疗周期长，费用高，疗效低；手术方法治疗创伤大，伤口愈合慢，后 遗症多且风险较高。近年来，随着超声介入治疗的不断发展，国内外已逐步开展 超声引导下经皮穿刺置管引流治疗肝脓肿的技术。此项治疗方法具有操作简便， 经济安全，创伤小，并发症少，疗效高等优点。 本文通过回顾 35 例肝脓肿患者行超声引导下经皮穿刺置管引流方法治疗的 病例，分析其临床疗效，总结其优缺点和注意事项。 1    Team report 5     Patience  材料与方法 （METHODS AND MATERIALS ）: 一、 临床资料 本组 35 例为 2003 年 1 月至 2006 年 5 月我院收治的肝脓肿住院患者。男性 20 例，女性 15 例，年龄 12~79 岁，平均 59 岁，24 例在 60 岁以上。肝脓肿直径 4.4~12cm ， 平均 6.8cm 。左肝脓肿 12 例，右肝脓肿 23 例；单发 29 例，多发 6 例。患者均有不 同程度的畏寒、发热、体温升高、肝区疼痛、消瘦、乏力等症状。血常规检查白 细胞总数及中性粒细胞明显身高。 二、 仪器与方法 1. 仪器