超声引导下经皮穿刺置管引流治疗肝脓肿临床疗效分析

Clinical efficacy of ultrasound-guided percutaneous catheter drainage in treatment of liver abscess

目的比较超声引导下经皮穿刺置管引流与手术切开置管引流治疗肝脓肿的临床疗效。方法选取2015年6月至2016年6月于汕头大学医学院第二附属医院普外科一病区行超声引导下经皮穿刺置管引流术治疗肝脓肿患者32例,列为超声组;选取2014年1月至2015年1月同院行手术切开置管引流治疗肝脓肿患者32例,列为手术组,回顾性分析2组患者治疗后的治愈率、体温恢复时间、白细胞计数恢复时间、拔管时间、住院总时间、住院总费用以及并发症发生情况并比较各项指标中2组数据之间的差异。结果超声组术后治愈率为96.88%,手术组为84.38%,2组间差异无统计学意义(χ2=2.94,P>0.05);超声组体温恢复时间[(3.13±1.04)d]、白细胞计数恢复时间[(4.06±1.32)d]、拔管时间[(10.03±1.18)d]、住院总时间[(14.03±1.15)d],明显较手术组的(7.09±1.42)、(7.28±1.30)、(14.06±1.16)、(18.03±1.21)d短,且2组比较差异具有统计学意义(t=12.197、9.831、13.784、14.091,P<0.05);超声组住院总费用[(8288.81±355.43)元]较手术组总费用[(12 771.98±337.93)元]减少,且2组间差异具有统计学意义(t=51.711,P<0.05);超声组术后切口出血1例,并发症发生率为3.13%,手术组术后切口感染3例,胸腔积液1例,切口出血1例,并发症发生率为15.63%,超声组术后并发症发生率远低于手术组,且2组间差异有统计学意义(χ2=6.56,P<0.05)。结论对于肝脓肿治疗,对比手术切开留置引流,超声引导下经皮穿刺留置引流术具有操作精准简单、创伤小、恢复快、并发症发生率低等优点,临床疗效显著。

Objective To compare the clinical efficacy of ultrasound-guided percutaneous catheter drainage versus incision and drainage in the treatment of liver abscess.Methods Thirty-two liver abscess patients who underwent ultrasound-guided percutaneous catheter drainage from June2015to June2016at our hospital and32liver abscess patients who underwent incision and drainage from January2014to January2015at our hospital were included in this study.The cure rate,time to recovery of body temperature to normal,time to recovery of white blood cell count,time to extubation,hospitalization length,hospitalization cost,and occurrence of complications were compared between the two groups.Results The cure rate was significantly higher in the catheter drainage group than in the incision and drainage group(96.88%vs84.38%,χ2=2.94,P>0.05).The time to recovery of body temperature to normal,time to recovery of white blood cell count,time to extubation,and hospitalization length were significantly shorter in the catheter drainage group than in the incision and drainage group[(3.13±1.04)d vs(7.09±1.42)d,(4.06±1.32)d vs(7.28±1.30)d,(10.03±1.18)d vs(14.06±1.16)d,(14.03±1.15)d vs(18.03±1.21)d;t=12.197,9.831,13.784,14.091,P<0.05],respectively.The hospitalization cost was significantly less in the catheter drainage group than in the incision and drainage group[(8288.81±355.43)yuan vs(12771.98±337.93)yuan,t=51.711,P<0.05].The complication rate was significantly lower in the catheter drainage group than in the incision and drainage group(3.13%vs15.63%,χ2=6.56,P<0.05).Conclusion Ultrasound-guided percutaneous catheter drainage has the advantages of precise and easy operation,mild trauma,quick recovery,and low complication rate over incision and drainage in the treatment of liver abscess.