肝脓肿的造影诊断及介入治疗探讨

Angiographic Diagnosis and Interventional Therapy of Hepatic Abscess

笔者报告经 Seldinger 氏法腹腔动脉或肝动脉插管 DSA 或/和 PUCK 摄片诊断肝脓肿9例。造影特征为:肝动脉不增粗;血管包绕征;腔壁环影征;脓腔相对低密度区。对5例脓腔直径>4cm 者,除1例外科手术切除(术后1天死亡)外,其余4例采用静脉套管针经皮穿刺脓腔置管介入治疗:抽出脓液,冲洗脓腔,脓腔造影,定期保留抗生素,甲硝唑溶液治疗,1～2周治愈出院,它明显优于内科及外科治疗。

Nine cases of hepatic abscess were diagnosed by Seldingers technigue. The angiographic features consisted of 1)no hepatic artery dilatation:2)vasculas encase- ment sign:3)cavitery ring sign 4)relative low density cavity sign.Five patients with ab- scess diameter over 4era,but one,performed partial hepatic resection ended other totally four underwent percutaneous transhepatic abscess intervertional therapy,including venous puncture drainage of pus;washing vomiea;periodic retained cathertee for antibiotic and an- tiamebic therapy.All four patients were off hospital one and two weeks later:The effect of interventinal therapy is better than that of medical therapy and surgery.