超声引导下经皮肝穿刺置管引流治疗肝脓肿并发症分析与防治

Analysis and management of complications in percutaneous aspirate and catheter drainage treatment for liver abscess

目的评价超声引导下经皮肝穿刺置管引流治疗肝脓肿的效果,探讨超声引导下置管引流肝脓肿的安全性及并发症的防治。方法回顾性研究超声引导下经皮穿刺置管引流治疗肝脓肿49例,其中经皮穿刺抽脓18例,套管针法及Seldinger法经皮穿刺置管引流31例,术后2小时、4小时床边超声检查。结果49例肝脓肿患者中1例于术后2小时出血,1例在4小时后出血,1例置管后脓腔破溃而中转手术,引流不畅再次穿刺2例,并发症发生率10.20%(5/49),除破溃1例外,其余全部治愈,治愈率97.95%(48/49)。结论超声引导下穿刺置管治疗肝脓肿安全可靠、并发症低、治愈率高。床边超声的应用有助于及时发现并发症,尽早采取有效治疗手段。

Objective To evaluate the effect of percutaneous puncture aspirate and catheter drainage treatment for liver abscess under the guidance of ultrasound,and discuss the safety of the treatment and managements of complications.Methods A total of 49 cases of liver abscess underwent percutaneous puncture aspirate（18 cases）and catheter drainage（31 cases）under the guidance of ultrasonography,and were followed up with bed-side ultrasound at 2 h and 4 h after operations.Results All cases were cured except one case of liver rupture,and the curing rate was 97.95%（48/49）,while the rate of complication was 10.20%（5/49）.Conclusion Under the guidance of ultrasonography,percutaneous puncture aspirate and catheter drainage treatment of liver abscess is safe,with low rate of complication and high curing rate.Moreover,bed-side ultrasound follow-up is helpful to the detection and management of complications.