彩超在肝脓肿诊断与治疗中的应用价值探讨

Application Value of Color Doppler Ultrasound in Diagnosis and Treatment of Liver Abscess

目的探讨彩超在肝脓肿中诊断和治疗中的应用价值。方法选取2013年8月~2015年9月在我院经过临床初步诊断怀疑为肝脓肿但是没有明确诊断的35例患者作为本次研究的对象,所有患者均行彩超进行诊断,对诊断结果明确的10例肝脓肿患者先予以保守治疗,如果治疗效果不佳则在超声引导下行穿刺抽脓联合局部应用抗生素注射治疗,观察患者的临床诊断和治疗效果。结果 35例患者中肝脓肿患者共10例,肝癌患者15例,肝血管瘤10例,10例肝脓肿患者经过保守治疗后,均治愈,病程在15 d^5个月,在此期间,通过复查超声,有4例患者肝内的病灶基本完全消失,有6例患者肝内病灶大部分被吸收,有少部分存留。在行穿刺抽脓过程中,有3例患者因为脓液较为黏稠,应用甲硝唑、庆大霉素加入生理盐水中后进行冲洗,并将注入的庆大霉素部分保留在脓腔内。10例肝脓肿患者中经过1次穿刺成功的有2例(20%),2次穿刺成功的有3例(30%),3次穿刺成功的有4例(40%)。结论彩超在肝脓肿诊断和治疗中的应用具有定位准确、创伤小、安全、准确的优势,可以缩短患者的病程,治疗效果明显。

Objective To evaluate the colour to exceed the application value in diagnosis and treatment of liver abscess. Methods 35 cases of after the preliminary clinical diagnosis of suspected for diagnosis of liver abscess but no clear patients were chosen as the research object from August 2013 to September 2015 in our hospital, all patients do colour to exceed diagnose, clear the diagnosis result of 10 patients with liver abscess with conservative treatment first, if the treatment effect is poor in ultrasound-guided downward puncture pumping pus joint local application of antibiotics injection treatment, observation of the clinical diagnosis and treatment of patients with effect. Results 35 cases of patients with a total of 10 patients with liver abscess, 15 patients with hepatocellular carcinoma and 10 cases of liver hemangioma, 10 patients with liver abscess after conservative treatment were cured, course of diseases in 15 d ~ 5 months, during this period, through the review of ultrasound, there are four basic cases of intrahepatic lesions completely disappear, most of intrahepatic lesions in 6 patients were absorbed, a few of them survived. Line puncture pumping pus in the process, there are 3 patients because of pus is relatively thick, used metronidazole, gentamicin after joining in the physiological saline to wash, and keep the injection of gentamicin part within the vomica. 2 cases of 10 cases of liver abscess were successfully punctured by 1 times（20%）, 2 times of puncture success in 3 cases（30%）, 3 times puncture success has 4 cases（40%）. Conclusion Colour to exceed the application in the diagnosis and treatment of liver abscess with positioning accuracy, the advantage of slight trauma, safe, accurate, can shorten the patient＇s course of the disease, treatment effect is obvious.