CT导引下经皮穿刺肺脓肿、脓胸治疗术

The percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance

目的 探讨CT导引下经皮穿刺诊断及治疗肺脓肿、脓胸的临床价值。方法 分析18例肺脓肿、脓胸患者经皮穿刺前后的临床表现及治疗经过,探索CT导引下经皮穿刺的适应症和介入治疗的方法,经皮肺穿刺诊断及治疗的可行性与必要性。结果 本组18例经皮穿刺肺脓肿、脓胸,经1次穿刺治疗治愈13例,经2次穿刺治疗治愈3例,经3次穿刺治疗治愈2例,其中2例肺脓肿经穿刺诊断为周围型肺癌后转入外科治疗。穿刺治疗后病人体温、白血球均下降至正常范围,16例经穿刺后7天至5周痊愈出院。结论 CT导引下经皮穿刺肺脓肿、脓胸不仅应用于临床诊断、鉴别诊断,而且应用于治疗,提高疗效,缩短疗程,避免外科手术,是一种简便易行、安全可靠的治疗方法。

Objective To study the indication, the procedure, the necessity and feasibility of the percutaneous interventional therapy of lung abscess and pyothorax under the CT guidance. Methods The group included 18 patients who received percutaneous interventional therapy of lung abscess and pyothorax. Results 13 patients were cured by a single procedure, 3 patients received twice intervention. Triple therapies were done in 2 patients. 2 cases out of 18 were eventually diagnosed as peripheral lung cancer. The body temperature and the WBC count returned to normal range after the procedures. 16 patients completely recovered in 1-5 weeks after the therapies. Conclusion The interventional therapy under CT guidance not only helps the diagnosis and differential diagnosis of chronic or acute lung abscess and pyothorax, but also shortens the course of treatment and avoids the open surgery. It is a safe, simple and convenient method.