超声引导介入性治疗细菌性肝脓肿的临床研究

Clinical study of ultrasound diagnostic technique and interventional treatment of bacterial liver abscess

目的探讨细菌性肝脓肿的超声引导下介入治疗效果。方法对在我院接受诊断与治疗的细菌性肝脓肿96患者进行超声检查及超声引导介入治疗。结果典型的超声表现为肝内不规则的圆形无回声或低回声包块,包膜光滑完整。脓腔的平均直径为(8.12±4.31)cm,其中脓肿直径<5cm 51例,脓肿直径≥5cm 45例。细针抽吸组和置管引流组中脓肿直径≥5cm患者经过治疗后随访3个月,其中细针抽吸组中治愈21例,治愈率为95.45%;置管引流组中治愈22例,治愈率为95.65%;经统计学分析发现细针抽吸组和置管引流组中脓肿直径≥5cm患者的治愈率比较无明显差异。细针抽吸组和置管引流组中脓肿直径<5cm患者经过治疗后随访3个月,其中细针抽吸组中治愈22例,治愈率为100.00%;置管引流组中治愈23例,治愈率为100.00%;经统计学分析发现细针抽吸组和置管引流组中脓肿直径<5cm患者的治愈率比较无明显差异。结论超声引导经皮穿刺组织活检能快速明确肝脓肿诊断,对于直径≥5cm直径<5cm的细菌性肝脓肿应分别首选超声引导下经皮肝穿刺置管引流术、细针抽吸术等介入性治疗方法简单、安全可靠。

Objective To investigate the bacterial liver abscess by ultrasound diagnostic technique and interventional therapeutic effect .Methods Bacterial liver abscess patients were examinated by ultrasound and they were treated by ultra‐sound guided percutaneous transhepatic fine needle aspiration and percutaneous transhepatic catheter drainage .The effect of treatment was compared in the two methods for in patients with abscess diameter 〈5 cm and above 5 cm .Results Typical ultrasound features of intrahepatic irregular circular anechoic or hypoechoic mass ,coating was smooth and com‐plete .Fine needle aspiration group and drainage group abscess diameter larger than 5 cm patients and 〈5 cm patients cure rate had no significant difference （χ2 =0 .08 ,0 .00 ,P 〉0 .05） .But for abscess with diameter larger than 5 cm patients , fine needle aspiration of hospitalization and the pus cavity group patients were lower than the disappearance time of catheter drainage group was significantly prolonged （ t = 6 .97 ,4 .56 , P〈 0 .05） .Conclusion Ultrasound guided percutaneous puncture biopsy can be quickly diagnosed as liver abscess .Bacterial liver abscess with a diameter greater than 5 cm or less than 5 cm should be preferred to the ultrasound guided percutaneous transhepatic catheter drainage ,fine needle aspiration of interventional therapy .Method is simple ,exact curative effect ,safety ,low cost ,which is worthy of clinical use .