超声引导下穿刺引流与抗生素灌注对术后感染性积液的疗效比较

Comparison of antibiotics and saline irrigation with tube drainage in the treatment of postoperative abdominal and pelvic infectious effusion

目的探讨生理盐水冲洗后置管引流、抗生素冲洗后置管引流、高浓度抗生素灌注后置管引流治疗感染性积液的疗效。方法回顾性分析2013年9月至2017年9月就诊于中国医学科学院肿瘤医院,术后形成腹盆腔感染性积液64例恶性肿瘤患者的临床资料,比较生理盐水冲洗后置管引流组和抗生素冲洗后置管引流组患者的积液面积变化、体温变化和置管时间等特征;比较抗生素冲洗后置管引流组和文献报道高浓度抗生素灌注后置管引流组患者的有效率及置管时间差异。结果生理盐水冲洗后置管引流组和抗生素冲洗后置管引流组患者的治疗有效率分别为68.6%和86.8%,置管时间分别为(11.9±8.4)d和(7.8±4.8)d,差异均有统计学意义(均P<0.05);而抗生素冲洗后置管引流组和高浓度抗生素灌注后置管引流组患者的治疗有效率分别为86.8%和100.0%,差异无统计学意义(P=0.067);置管时间分别为(7.8±4.8)d和(3.6±3.1)d,差异有统计学意义(P<0.001)。结论在术后感染性积液治疗方法中,高浓度抗生素灌注后置管引流对感染性积液的治愈率高、置管时间短,值得临床推广。

Objective To compare the efficiency of saline irrigation, antibiotics irrigation and high-concentration antibiotics perfusion with tube drainage in the treatment of infectious effusion. Methods Clinical and sonographic features of abdominal and pelvic infectious effusion of 64 patients with malignant tumor collected from September 2013 to September 2017 were retrospectively analyzed. The changes of effusion size and temperature, catheterization time were evaluated in saline irrigation group and antibiotics irrigation group. The catheterization time was compared between antibiotics irrigation group and high-concentration antibiotics perfusion group. Results The effective rates of the saline irrigation group and the antibiotics irrigation group were 68.6% and 86.8%, respectively, and the times of catheterization were 11.9±8.4 days and 7.8±4.8 days, respectively, with significantly statistical difference (both P<0.05). However, the effective rates of the antibiotics irrigation group and the high concentration antibiotic perfusion group were 86.8% and 100.0%, respectively (P=0.067), while the times of catheterization were 7.8±4.8 days and 3.6±3.1 days, respectively (P<0.001). Conclusion The antibiotic irrigation with tube drainage, especially the high concentration perfusion is more effective than saline in the treatment of abdominal and pelvic infection effusion.