超声造影联合超声引导下经皮穿刺置管引流术治疗肝脓肿的应用价值

Clinical application value of contrast-enhanced ultrasound combined with ultrasound-guided percutaneous catheter drainage in the treatment of hepatic abscess

目的探讨超声造影联合超声引导下经皮穿刺置管引流术治疗肝脓肿的临床效果。方法选择本院2015年1月~2019年4月收治的39例肝脓肿患者,随机分为实验组20例和对照组19例。实验组穿刺前行超声造影检查,对穿刺点及引流管放置区进行精准定位。对照组在常规超声引导下行经皮穿刺置管引流。比较两组患者治愈率、体温恢复时间、白细胞计数恢复时间、引流管拔除时间、住院时间、术中及术后并发症等,进行对比分析。结果39例患者均行超声引导下穿刺置管引流治疗,所有患者均一次性穿刺成功,术中无出血、周围脏器损伤、肝破裂以及胆漏等并发症。实验组患者体温及白细胞复常时间、引流管拔除时间、住院时间均显著短于对照组,两者差异具有统计学意义(P<0.05)。两组治愈率及术后并发症比较无统计学意义。结论超声造影能准确评估病灶液化坏死区域,在精准引导、定位超声引导下肝脓肿穿刺置管引流中有着绝对优势,值得临床推广应用。

Objective To explore and study the effect of contrast-enhanced ultrasound(CEUS)combined with ultrasound-guided percutaneous catheter drainage on liver abscess.Methods Thirty-nine patients with liver abscess admitted to our hospital from January 2015 to Apirl 2019 were randomly divided into experimental group and control group,with 20 cases in the experimental group and 19 cases in the control group.CEUS was performed before puncture in the experimental group to precisely locate the puncture point and drainage tube placement area.The control group was routinely treated with ultrasound-guided percutaneous catheterization and drainage.The cure rate,time to recovery of body temperature to normal,time to recovery of white blood cell count,time to extubation,hospitalization length,the intraoperative and postoperative complications were compared between the two groups.Results All the 39 patients were treated with ultrasound-guided puncture and catheter drainage,and all the patients were successfully punctured once without intraoperative and complications such as bleeding,peripheral organ injury,liver rupture and bile leakage.The patients in the experimental group had significantly shorter body temperature recovery time,leukocyte recovery time,drainage tube removal time and hospitalization time than the control group,with statistically significant differences between the two groups(P<0.05),but no statistically significant differences in cure rate and postoperative complications.Conclusion Contrast-enhanced ultrasonography can accurately evaluate the liquefactive necrotic area of the lesion,and has an absolute advantage in puncture and drainage of hepatic abscess under precise guidance and localization ultrasound guidance,which is worthy of clinical promotion and reference.