肝动脉化疗栓塞术后并发肝脓肿5例治疗分析

The treatment of liver abscess occurred after transcatheter arterial chemoembolization:report of five cases

目的探讨肝动脉化疗栓塞术(TACE)后并发肝脓肿的原因及治疗。方法总结我院2008年3月至2010年9月治疗的原发性肝癌患者353例,肝转移癌102例;其中有外科手术史患者98例;共并发肝脓肿5例,3例并发于原发性肝癌,2例并发于肝转移癌。采用在X线透视引导下行经皮穿刺脓肿引流术,术后给予抗生素冲洗。结果所有患者经治疗后临床症状明显缓解,脓腔于术后12～25 d愈合或明显缩小。结论 TACE术后肝脓肿由多种原因导致,采用经皮穿刺脓肿引流是治疗TACE术后并发肝脓肿的有效手段。

Objective To discuss the causes and the treatment of liver abscess that developed after transcatheter arterial chemoembolization（TACE）for hepatic carcinoma.Methods A total of 353 patients with primary hepatic carcinoma（PHC）and 102 patients with metastatic hepatic carcinoma（MHC）,encountered in authors＇ hospital during the period from March 2008 to September 2010,were collected.All patients had been treated with TACE.Ninety-eight patients had surgical history.Liver abscess was complicated in 5 patients with PHC（n = 3）or MHC（n = 2）.Under fluoroscopic guidance,percutaneous transhepatic catheter drainage together with antibiotic lavage was performed in all five cases with liver abscess.Results After percutaneous transhepatic catheter drainage and antibiotic lavage,the clinical symptoms caused by liver abscess were markedly improved in all 5 cases.The lesions decreased remarkably in size or even disappeared within 12 ～ 25 days.Conclusion The liver abscess occurred after TACE may be caused by many reasons.Percutaneous transhepatic catheter drainage coupled with antibiotic lavage is an effective therapeutic measure.