TACE术后肝脓肿形成的原因及临床分析

Causes and clinical analysis of liver abscess after TACE

目的分析肝动脉化疗栓塞术治疗原发性肝癌术后致肝脓肿的易感因素,为临床治疗和预防介入术后肝脓肿提供证据。方法对2018年前我院收治的HCC患者行TACE术后2例肝脓肿形成的易感因素及诊治方法进行回顾性研究。结果 2例患者均CT检查、结合临床表现及血常规,早期明确诊断,采用CT引导下穿刺置管、强力负压引流并敏感抗生素治疗,脓肿均治愈,2例均预后良好。结论 HCC患者行TACE术后肝脓肿形成的易感因素有肿瘤巨大、合并胆道疾病手术史、栓塞彻底等,积极穿刺抽脓或引流结合抗生素的应用是治疗TACE后肝脓肿的良好方法,脓肿治愈后往往可致肿瘤坏死更加彻底、完全,对易发因素患者术前或术后应采用抗生素预防。

Objective To analyze the predisposing factors of hepatic abscess after hepatic arterial chemoembolization(TACE) for primary liver cancer and provide evidence for clinical treatment and prevention of hepatic abscess after interventional operation. Methods Two cases of liver abscess after TACE in our hospital before 2018 were studied retrospectively. Results CT examination combined with clinical manifestation and blood routine, early diagnosis, CT guided puncture catheter, strong negative pressure drainage and sensitive antibiotic treatment, abscess were all cured, and 2 cases had a good prognosis. Conclusion Liver abscess after TACE in patients with HCC The risk factors are huge tumor, complicated with biliary tract disease, complete embolization, etc. The positive puncture or drainage combined with antibiotics is a good method to treat liver abscess after TACE, which often leads to tumor necrosis more thoroughly after the abscess is cured. All patients with risk factors should be prevented by antibiotics before and after operation.