CT引导下穿刺引流治疗腹盆腔脓肿的效果分析

Effects of CT guided puncture drainage in treatment of abdominal and pelvic abscess

目的探讨CT引导下穿刺引流治疗腹盆腔脓肿的效果。方法选取医院诊治的腹盆腔脓肿患者100例为研究对象,均接受CT引导下经皮腹盆腔穿刺引流,观察患者住院时间、拔管时间、引流时间和脓肿变化情况,比较穿刺前后患者白细胞计数及体温的变化,综合评估穿刺引流治疗情况。结果所有患者穿刺均成功,置管后CT扫描显示引流管位置正常。10例行多次穿刺,原因包括引流不畅5例,积液量增加4例,不慎自行拔除1例。穿刺后1~3 d,患者的体温、白细胞计数均呈明显下降趋势(P<0.05);穿刺3 d后超声检查显示,脓肿直径较穿刺前有明显缩小(P<0.05)。住院期间引流无异常,疗效评估为优80例(80.0%),良18例(18.0%),差2例(2.0%)。出院后随访3个月,脓肿消失,无残留病灶、复发及出血、脏器损伤等并发症发生。结论 CT引导下穿刺引流治疗腹盆腔脓肿定位准确,引流效果好,安全性好,值得临床推广。

Objective To explore the effects of CT guided puncture drainage in the treatment of abdominal and pelvic abscess. Methods A total of 100 patients with abdominal and pelvic abscess admitted to our hospital were selected and treated with CT guided percutaneous pelvic cavity puncture drainage. The length of stay （LOS）, extubation time, drainage time and abscess changes in patients were observed. The changes in white blood cell count and body temperature of patients before and after the puncture were compared to comprehensively assess the effects of puncture drainage. Results The puncture was successful in all patients. After intubation, the CT scanning showed that the drainage tube is in normal position. Totally 10 patients received several punctures, because five ones encountered inadequate drainage, four ones had the increase of effusion and one took out the drainage tube carelessly. One to three days after the puncture, the body temperature and white blood cell count of patients decreased significantly （P 〈 0.05）; three days after the puncture, ultrasonic inspection showed that the diameter of the abscess was much smaller than that before the puncture（P〈 0.05）. During the hospitalization, the drainage had no abnormalities. The effect evaluation was excellent in 80 patients （80.0%）, good in 18 ones （18.0%） and poor in two ones （2.0%）. During the three-month follow-up visit after discharge, the abscess disappeared. No residual focus, recurrence and bleeding, organ injury and other complications occurred. Conclusion CT guided puncture drainage in treatment of abdominal and pelvic abscess ensures accurate location, has good drainage effects and high safety, and is worthy of clinical popularization.