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目的评价超声引导下经皮肝穿刺治疗细菌性肝脓肿的临床应用价值。方法对临床确诊为细菌性肝脓肿的49例患者进行超声引导下经皮肝穿刺治疗,其中22例行单纯细针抽吸术(抽吸组),26例行置管引流术(置管组),1例抽吸术后1周脓腔无明显缩小而行置管引流术(抽吸+置管组);同时配合静脉抗炎、全身支持治疗。结果超声引导下经皮肝穿刺细针抽吸或置管引流治疗后,患者体温恢复正常、白细胞计数恢复正常及脓腔消失时间分别为(2.8±0.6)d、(3.2±0.5)d、(14.6±4.2)d。所有患者均无并发症,术后3个月复查超声脓腔均消失,超声引导下经皮肝穿刺治疗细菌性肝脓肿的治愈率为100%。结论超声引导下经皮肝穿刺细针抽吸和置管引流术具有简便经济、创伤小、并发症低、治愈率高等优点,成为细菌性肝脓肿首选治疗方法。
Objective To evaluate the clinical value of ultrasound-guided percutaneous transhepatic puncture in the treatment of bacterial liver abscess. Methods Forty-nine patients with clinically diagnosed bacterial liver abscess underwent ultrasound-guided percutaneous transhepatic liver biopsy. Twenty-two patients underwent simple needle aspiration (suction group) and 26 patients received catheter drainage (catheter group ), One case of abscess was not significantly reduced in 1 week after catheter abstraction and catheter drainage (suction plus catheter group); at the same time with intravenous anti-inflammatory and systemic supportive treatment. Results After percutaneous transhepatic needle aspiration or catheter drainage guided by ultrasound, the body temperature returned to normal, the white blood cell count returned to normal, and disappearance of abscess were (2.8 ± 0.6) d and (3.2 ± 0.5) d, respectively ( 14.6 ± 4.2) d. All patients had no complication. Ultrasound abscess disappeared 3 months after operation. The cure rate of bacterial liver abscess treated by ultrasound guided percutaneous liver was 100%. Conclusion Ultrasound-guided percutaneous transhepatic needle aspiration and catheter drainage is simple and economical, less trauma, low complication, high cure rate, and become the treatment of choice for bacterial liver abscess.