超声引导下穿刺置管引流及药物冲洗在盆腔脓肿治疗中的应用价值

Application value of ultrasound-guided puncture catheter drainage and drug flushing in the treatment of pelvic abscess

目的探讨超声引导下穿刺置管引流及药物冲洗在盆腔脓肿治疗中的应用价值。方法选取2017年3月至2022年3月于甘肃省人民医院接受治疗的80例盆腔脓肿女性患者作为研究对象,按照随机数字表法分为对照组与治疗组,每组40例。两组均行超声引导下穿刺置管引流术,对照组给予0.9%氯化钠溶液冲洗,治疗组给予药物冲洗治疗。比较两组治疗前后中性粒细胞计数、白细胞介素-1β(IL-1β)、单核细胞趋化蛋白-1(MCP-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平及病原菌检出率、症状体征消失时间、血常规恢复正常时间、体温恢复正常时间、脓腔消失时间、住院时间、临床疗效及并发症发生率。结果治疗5d后,两组中性粒细胞计数、IL-1β、MCP-1及GM-CSF水平均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。对照组脓液标本中共分离出30株菌株,治疗组分离出29株菌株。治疗5d后,治疗组革兰阴性菌、革兰阳性菌检出率均低于治疗前和对照组,差异有统计学意义(P<0.05);但两组治疗前后组内、组间真菌检出率及对照组治疗前后革兰阴性菌、革兰阳性菌检出率比较差异均无统计学意义。治疗组症状体征消失时间、血常规恢复正常时间、体温恢复正常时间、脓腔消失时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗组治疗总有效率为100.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论超声引导下穿刺置管引流及药物冲洗治疗盆腔脓肿患者疗效显著,可有效抑制机体炎症反应,消除病原菌,改善患者临床症状体征,且无严重并发症发生。

Objective To investigate the application value of ultrasound-guided puncture catheter drainage and drug flushing in the treatment of pelvic abscess.Methods A total of 80 female patients with pelvic abscess treated in Gansu Provincial People's Hospital from March 2017 to March 2022 were selected as the study subjects,and they were divided into the control group and the treatment group by random number table method,with 40 cases in each group.Both groups were treated with ultrasound-guided puncture catheter drainage,the control group was given 0.9%sodium chlo-ride solution flushing,and the treatment group were given drug flushing.The levels of neutrophil count,interleukin-1β(IL-1β),monocyte chemoat-tractant protein-1(MCP-1),granulocyte-macrophage colony-stimulating factor(GM-CSF)and pathogenic bacteria detection rate before and after treatment,the symptoms and signs disappearance time,blood routine return to normal time,body temperature return to normal time,pus cavity disap-pearance time,hospitalization time,clinical efficacy and the incidence of complications were compared between the two groups.Results After 5 d of treatment,the neutrophil count,IL-1β,MCP-1 and GM-CSF levels of the two groups were lower than those before treatment,and the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).A total of 30 strains were isolated from the pus samples taken of the control group and 29 strains were isolated of the treatment group.After 5 d of treatment,the detection rates of Gram-nega-tive bacteria and Gram-positive bacteria in the treatment group were lower than those before treatment and the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the fungal detection rate within and between the two groups before and after treatment,and the detection rate of Gram-negative bacteria and Gram-positive bacteria in the control group before and after treat-ment.The symptoms and signs disappeared time,blood routine return to normal time,body temperature return to normal time,pus cavity disappeared time and hospitalization time in the treatment group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate in the treatment group was 100.00%,which was higher than 80.00%in the control group,and the difference was statisti-cally significant(P<0.05).There was no significant difference in the incidence of complications between the two groups.Conclusion Ultrasound-guided puncture catheter drainage and drug flushing are effective in the treatment of patients with pelvic abscess,can effectively inhibit inflamma-tion,eliminate pathogens,improve clinical symptoms and signs,enhance clinical efficacy,and no serious complications occurred.