细菌性肝脓肿穿刺引流联合脓腔敏感抗生素灌注的疗效观察

Clinical effect of puncture and catheter drainage combined with effective antibiotic perfusion of abscess cavity on the treatment of bacterial liver abscess

目的:探讨细菌性肝脓肿穿刺置管引流联合脓腔敏感药物灌注的临床疗效。方法:选取我院消化内科及肝胆外科2014年8月至2019年10月间收治的52例肝脓肿患者临床资料,按照临床治疗方式的不同分为观察组与对照组。观察组28例,行经皮肝穿刺置管引流联合敏感抗生素灌洗脓腔治疗;对照组24例,经皮肝穿刺置管引流联合生理盐水冲洗脓肿腔治疗。比较两组患者临床治疗效果、临床指标缓解时间及实验室指标缓解时间。结果:观察组患者临床指标缓解时间及实验室观察指标白细胞(white blood cell,WBC),C反应蛋白(C reactive protein,CRP)及降钙素原(proalcitonin,PCT)恢复正常时间短于对照组,差异有统计学意义(P<0.05)。观察组显效22例,总体有效率为89.3%;对照组显效11例,总体有效率为62.5%,观察组总体有效率高于对照组(P<0.05)。结论:肝脓肿置管引流联合敏感抗生素脓腔灌注安全、有效,可临床推广应用。

Objective:To investigate the clinical effect of puncture and catheter drainage combined with effec⁃tive antibiotic perfusion of abscess cavity on the treatment of bacterial liver abscess.Methods:A retrospective analy⁃sis was performed for the clinical data of 52 patients with liver abscess who were treated in Department of Gastroen⁃terology and Department of Hepatobiliary Surgery in our hospital from August 2014 to October 2019,and the pa⁃tients were divided into observation group and control group according to the clinical treatment method.The 28 pa⁃tients in the observation group were treated with percutaneous transhepatic drainage combined with effective antibiot⁃ic perfusion of abscess cavity,and the 24 patients in the control group were treated with percutaneous transhepatic drainage combined with normal saline irrigation of abscess cavity.The two groups were compared in terms of treat⁃ment outcome and time to the remission of clinical indices and laboratory markers.Results:Compared with the con⁃trol group,the observation group had significantly shorter time to the remission of clinical indices and time for the laboratory markers white blood cell count,C-reactive protein,and RCT to return to normal(P<0.05).In the observa⁃tion group,22 patients were markedly improved,with an overall response rate of 89.3%,and in the control group,11 patients were markedly improved,with an overall response rate of 62.5%.The observation group had a signifi⁃cantly higher overall response rate than the control group(P<0.05).Conclusion:Catheter drainage combined with effective antibiotic perfusion of abscess cavity is safe and effective in the treatment of liver abscess and thus holds promise for clinical application.