肝脓肿超声引导下介入治疗的临床观察

胡海燕　韩秀清　韩转宁

[摘 要] 目的：探讨超声引导下经皮介入治疗肝脓肿疗效。方法：对2014年6月—2015年10月期间我院收治的56例肝脓肿患者资料进行回顾性分析，根据治疗方式不同分为介入组（26例）和手术组（30例）。介入组超声引导下介入治疗，手术组行开腹手术脓肿切开引流术，比较2组并发症发生情况。结果：介入组术后体温恢复正常时间、WBC恢复正常时间、住院时间、住院费用明显低于手术组，差异有统计学意义，2组引流管拔管时间差异无统计学意义；介入组患者临床治愈率略低于手术组（96.15% VS 100%），组间差异无统计学意义。介入组术后出血、感染、术后麻醉并发症等总并发症的发生率明显低于手术组（0 vs 33.3%），差异有统计学意义，P<0.05。结论：超声引导下经皮穿刺肝脓肿介入治疗，创伤小、恢复快、治愈率高、并发症少。

[关键词] 肝脓肿；超声引导；介入治疗

中图分类号：R453 文献标识码：B 文章编号：2095-5200（2016）03-011-03

[Abstract] Objective： To evaluate the efficacy of ultrasound-guided percutaneous treatment for liver abscess. Methods： The data of 56 cases of patients with liver abscess in our hospital from June 2014 to October 2015 were retrospectively analyzed. According to treatment， the patients were divided into intervention group （26 cases） and surgical group （30 cases）. Intervention group was treated by ultrasound-guided intervention， surgical group underwent laparotomy incision and drainage of abscess， and complications were compared between the two groups. Results： In intervention group， time for body temperature returned to normal， WBC recovery time， hospital stay， hospital costs， were all significantly lower than those of surgery group， the difference was statistically significant， the difference in time for drainage tube extubation between two groups was not statistically significant； the cure rate of patients in clinical intervention group is slightly lower than that of surgery group （96.15% vs 100%）， there was no statistically significant difference between two groups. The incidence of surgical complications of bleeding， infection， anesthesia complications after operation in intervention group was significantly lower than those of surgical group （0 vs 33.3%）， the difference was statistically significant（P<0.05）. Conclusions： There was smaller trauma， quicker recovery， higher cure rate and few complications in ultrasound-guided percutaneous interventional treatment of liver abscess.

[Key words] liver abscess； ultrasound-guided； interventional therapy

肝脓肿是肝脏继发感染性疾病，多由于细菌或阿米巴原虫感染，形成多发性小脓肿，进而融合成较大脓肿。肝脓肿的主要治疗方式有药物保守治疗、超声引导下介入治疗和外科手术治疗，保守治疗适用于小脓腔且耗时长，较大脓腔采用外科手术及超声介入疗效较为肯定 [1-2]。本研究对我院收治的56例肝脓肿患者的临床资料进行回顾性研究，对外科及介入两种治疗方式的有效性和预后进行比较。

1 资料与方法

1.1 一般资料

回顾性分析2014年1月—2015年10月期间我院非保守治疗56例肝脓肿患者资料。所有患者均存在肝脓肿急性发作症状如肝区疼痛、发热、黄疸等，血常规检查白细胞增高，经腹部超声和CT检查确诊为肝脓肿。……