肝包虫囊肿细菌感染病原菌分布、影像学表现及超声引导下穿刺不同处理措施对治疗疗效的影响

Distribution,imaging performance and efficacy of different treatment measures of ultrasound guided puncture on the treatment of hepatic hydatid cyst patients with bacterial infections

目的探讨肝包虫囊肿细菌感染病原菌分布、影像学表现及超声引导下穿刺不同处理措施对治疗疗效的影响,为肝包虫囊肿细菌感染的临床治疗提供参考依据。方法收集2013年1月-2015年12月在医院行超声引导下穿刺治疗94例肝包虫囊肿细菌感染患者临床资料,均在术前行超声影像学检查及超声引导下穿刺治疗,比较不同感染分期患者影像学表现。结果 94例患者共培养出48株病原菌,以大肠埃希菌为主,共32株占66.67%;感染前期患者84.62%囊肿张力偏低,感染期患者91.53%囊壁塌陷、化脓期患者83.33%囊壁张力高、感染后期患者100.00%囊壁张力低;硬化剂为无水乙醇时治愈率为100.00%高于高渗盐水的治愈率80.95%(P<0.05)。结论大肠埃希菌是引起肝包虫囊肿细菌感染的主要病原菌,囊肿感染分期不同时影像学表现各有特点,超声引导下穿刺治疗时选用无水乙醇治疗效果明显优于高渗盐水。

OBJECTIVE To investigate the distribution,imaging performance and efficacy of different treatment measures of ultrasound guided puncture on the treatment of hepatic hydatid cyst patients with bacterial infections,so as to provide references for clinical treatment of of hepatic hydatid cyst patients with bacterial infections.METHODS Clinical data of 94 cases of hepatic hydatid cyst patients with bacterial infections treated with ultrasound guided puncture from Jan.2013 to Dec.2015 were collected.The patients were all treated with preoperative ultrasound imaging and ultrasound guided puncture,and the imaging performance of patients at different stages of infection were compared.RESULTS Totally 48 strains of pathogenic bacteria were cultured,including 32 strains of Escherichia coli,accounting for 66.67%.In the early stage of infection,84.62% of the cysts tension of the patients were low,in the infection stage,91.53% of cyst wall of the patients were collapsed,in the purulent stage of infection,83.33% of cyst wall tension of the patients were high,and in the late stage of infection,100% of cyst wall tension of the patients were low.The cure rate was 100% when absolute ethyl alcohol as hardening agent,which was higher than 80.95% when hypertonic saline as hardening agent（P〈0.05）.CONCLUSION E.coli is the main pathogenic bacteria in hepatic hydatid cyst patients with bacterial infections,imaging performance have different features at different stages of infection,and the treatment effect of ultrasound guided puncture using anhydrous ethanol was significantly better than that of hypertonic saline.