14例肝癌射频消融术后肝脓肿的临床特点分析

Clinical characteristics of 14 patients with liver abscess after radiofrequency ablation for liver cancer

目的探讨肝癌射频消融术(radiofrequency ablation,RFA)后并发肝脓肿的临床特点。方法回顾性分析我院2013年1月至2017年12月RFA治疗后消融病灶出现肝脓肿患者14例。观察肝脓肿患者的临床表现、实验室检查、影像学检查、肝脓肿穿刺液或引流液细菌培养和血培养及患者的治疗和转归等。结果 14例肝脓肿患者均出现发热、寒战,化验感染指标(血WBC、PCT、CRP等)升高,腹部B超、CT或MRI检查显示消融病灶区域出现坏死液化、积气或液气平,肝脓肿穿刺证实肝脓肿,8例脓液培养出细菌。14例肝脓肿均经有效抗生素治疗和脓肿穿刺或置管引流冲洗治愈。结论 RFA术后肝脓肿的及时诊断、有效的抗生素使用和充分引流,是治疗肝脓肿的有效手段。

Objective To investigate the clinical characteristics of liver abscess after radiofrequency ablation (RFA) for liver cancer. Methods A retrospective analysis of 14 patients with liver abscess who underwent RFA for liver cancer was performed in our hospital from Jan. 2013 to Dec. 2017. The clinical manifestation, laboratory examination, imaging examination, bacterial culture of liver abscess puncture fluid or drainage fluid and blood culture, the treatment and prognosis of 14 patients were observed. Results Fever and shivering were found in all 14 cases of liver abscess. The infection indexes (blood WBC, PCT, CRP, etc.) were increased. The abdominal B-ultrasound, CT or MRI showed necrosis liquefaction, gas accumulation or liquid gas leveling in the ablation focus area. Liver abscess was further confirmed by puncture of the lesion and 8 cases of pus culture were positive. Fourteen cases of liver abscess were cured by effective antibiotic treatment and abscess puncture or drainage. Conclusion Timely diagnosis of liver abscess after RFA, use of valid antibiotics and adequate drainage are effective methods for treatment of liver abscess after RFA for liver cancer.