双平面腔内超声引导下经会阴置管引流术治疗术后盆腔包裹性积液的效果

Biplanar Intraluminal Ultrasound-Guided Transperineal Drainage for Postoperative Pelvic Encapsulated Effusion

目的总结双平面腔内超声引导下经会阴治疗术后盆腔包裹性积液的经验,为临床诊疗提供依据。方法回顾性分析双平面腔内超声探头引导下、经会阴穿刺置管引流的20例术后盆腔包裹性积液患者的临床资料,记录操作置管成功率、脱管率、白细胞指标以及引流效果随访情况。结果20例患者均采用seldinger穿刺法一次性操作成功,操作时间(9.1±2.16)min,引流通畅,操作过程中未见患者有明显不适。反复冲洗并持续引流后,复查超声示盆腔无明显积液及其他不适后拔管,带管时间为(4.35±1.19)d。引流后白细胞为(8.72±2.56)×10^(9)L^(-1),较操作前的(14.82±3.52)×10^(9)L^(-1)明显降低(P<0.05)。术后未见出血、切口感染、直肠损伤等并发症,带管过程中均无脱管。结论双平面腔内超声探头引导下经会阴置管引流术治疗术后盆腔包裹性积液安全、有效、并发症少。

Objective To summarize the experience of treating postoperative pelvic encapsulated effusion with biplanar intraluminal ultrasound-guided transperineal drainage,and to provide the evidence for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on clinical data of 20 patients with postoperative pelvic encapsulated effusion who underwent transperineal puncture and catheter drainage under the guidance of biplanar intracavity ultrasound.The success rate of catheter placement,dislodgement rate,white blood cell count and drainage efficacy were statistically analyzed.Results All the 20 patients underwent successful catheter placement using the Seldinger technique.The average operation time was(9.1±2.16)minutes.The drainage is unobstructed and no obvious discomfort was observed in the patients during the operation.After repeated irrigation and continuous drainage,ultrasound reexamination showed no obvious fluid accumulation in the pelvic cavity or other discomfort.The catheter was removed after(4.35±1.19)days.The number of white blood cells((8.72±2.56)×10^(9)L^(-1))after drainage was significantly lower than that before operation((14.82±3.52)×10^(9)L^(-1))(P<0.05).No postoperative complications such as bleeding,incision infection and rectal injury occurred,and no catheter detachment was found in the patients.Conclusion Biplanar intraluminal ultrasound-guided transperineal drainage is a safe and effective approach with few complications in the treatment of postoperative pelvic encapsulated effusion.