介入性超声置管引流在外科术后腹腔液性包块处理中的应用价值

The application value of interventional ultrasound catheter drainage in the treatment of postoperative abdominal fluid mass

目的探讨介入性超声置管引流在外科术后腹腔液性包块处理中的应用价值。方法对我院外科手术后超声检查发现46例腹腔液性包块,分为三类:透声好12例(26.1%);透声较差16例(34.8%);透声差18例(39.1%),在超声引导下经皮穿刺分别置入8Fr、10Fr、12Fr弯型引流管,观察置管成功率和引流液性质、引流效果。结果 46例中,阑尾炎术后右下腹部脓肿10例、血肿2例、渗出液4例,胃肠术后肠瘘肠漏液体3例、结肠旁脓肿6例、渗出液4例,肝胆外科术后肝周间隙积血2例、积脓1例、胆汁2例,胆囊窝积液3例,剖宫产术后子宫前间隙脓肿4例、血肿2例,经皮肾镜术后肾周脓肿1例,脾周积脓2例。一次置管成功45例(97.8%),置管失败1例(2.2%),二次置管3例(6.5%),持续引流时间8Fr为(12±5)d,10Fr为(10±4)d、12Fr为(12±6)d。结论介入性超声置管引流为外科术后腹腔液性包块的处理提供了有效的治疗方法,以其精准、微创、安全、有效值得临床推广。

Objective To investigate the application value of interventional ultrasound catheter drainage in the treatment of abdominal fluid. Methods A total of 46 cases of abdominal fluid were found in the postoperative ultra- sonography of our hospital, and there were three types of abdominal fluid： the sound was good in 12 cases （26.1%）. Sixteen cases with poor penetration （34.8%）; In 18 cases （39.1%）, the ultrasonic guided percutaneous puncture was in- serted into 8Fr, 10Fr, 12Fr curved drainage tube to observe the success rate of catheter and the properties of drainage fluid and drainage. Results In 46 cases, l0 cases of postoperative lower abdominal abscess appendicitis, hematoma ~n 2 cases, exudate, 4 cases of gastric intestinal fistula postoperative intestinal leakage liquid in 3 patients, 6 patients with colon side abscess, exudate in 4 cases, liver and gallbladder surgery postoperative peripheral hepatic interstitial hemorrhage in 2 cases, empyema in 1 case, 2 cases of bile and gallbladder fossa effusion, 3 cases of uterus after ce- sarean section before the clearance abscess in 4 cases, 2 cases of hematoma, percutaneous nephroscope postoperative renal week abscess in 1 case, splenic weeks empyema in 2 cases. In the case of a single catheter, 45 cases （97.8%）, 1case of catheter failure （2.2%）, 3 cases of secondary catheter （6.5%）, and continuous drainage time of 8Fr were 12 plus or minus 5 d, 10Fr 10 plus or minus 4 d, and 12Fr 12 plus or minus 6 d. Conclusion Interventional ultrasound catheter drainage provides an effective treatment method for the treatment of postoperative abdominal fluid bundle block, which is worthy of clinical promotion with precision, minimally invasive, safe and effective.