超声引导下经皮穿刺置管引流治疗阑尾周围脓肿的临床分析

Clinical analysis of ultrasound-guided percutaneous drainage for the treatment of abscess around the appendix

目的探讨超声引导下经皮穿刺置管引流联合抗生素治疗阑尾周围脓肿的安全性及可行性。方法回顾性分析福建省立医院和省立金山医院2015年1月~2018年1月收治的阑尾周围脓肿患者共156例,按治疗方式不同分为引流+抗生素组(引流组)和单纯抗生素治疗组(对照组),比较两组患者症状体征改善时间、白细胞计数恢复时间、抗生素使用时间、住院天数、并发症及治愈率、有效率等。结果引流组体温及白细胞计数恢复正常时间、抗生素使用时间、总住院天数均短于对照组,差异有统计学意义(P<0.05);引流组中转手术3例,对照组中转手术4例,差异无统计学意义(P>0.05);两组感染性休克、肠梗阻、肠瘘等并发症发生率比较差异无统计学意义(P>0.05);引流组的治疗有效率和治愈率均高于对照组,差异有统计学意义(P<0.05)。结论超声引导下经皮穿刺置管引流术联合治疗阑尾周围脓肿是安全可行的,患者恢复快、住院时间短,值得临床应用推广。

Objective To investigate the safety and feasibility of ultrasound-guided percutaneous drainage combinedwith antibiotics in the treatment of abscess around the appendix. Methods 156 cases of abscess around the appendixadmitted in Fujian Provincial Hospital and Fujian Provincial Jinshan Hospital from January 2015 to January 2018 wereretrospectively analyzed. The patients were divided into drainage＋antibiotic group（drainage group） and antibiotic treatment group（control group） according to different treatment methods. The improvement time of symptoms and signs, whiteblood cell count recovery time, antibiotic use time, hospitalization days, complications and cure rate, and efficiency between two groups were compared. Results The recovery time of temperature and white blood cell count, antibiotic usetime and total hospitalization days of the drainage group were shorter than those of the control group, and the differencewas statistically significant（P〈0.05）. There were 3 cases of surgical intervention in the drainage group and 4 cases ofsurgical intervention in the control group. The difference was not statistically significant（P〉0.05）. There was no significantdifference in the complications rates of septic shock, intestinal obstruction and intestinal fistula between the two groups（P〉0.05）. The effective rate and cure rate of the drainage group were higher than those of the control group, the difference was statistically significant（P〈0.05）. Conclusion Ultrasound-guided percutaneous drainage and drainage is safeand feasible in the treatment of abscess around the appendix. The patient recovers quickly and the hospital stay isshort. It is worthy of clinical application.