论文部分内容阅读
目的分析超声造影在肝脓肿患者诊治中的评估应用,提高临床对肝脓肿患者认知及治疗水平。方法回顾性分析2010年10月-2012年9月医院收治的68例肝脓肿患者临床资料,整理分析患者治疗前后超声造影改变及病原菌检出情况,分析超声造影在肝脓肿诊断治疗中的作用。结果 68例患者经病理穿刺或手术病理确诊,52例为细菌性肝脓肿,52份穿刺液共检出病原菌63株,肺炎克雷伯菌24株、大肠埃希菌18株、铜绿假单胞菌11株,屎肠球菌3株,7例检出真菌感染,另检出9例阿米巴原虫感染;治疗前超声检查结果,59例患者经常规超声确诊为肝脓肿,9例患者经超声造影确诊为肝脓肿;68例患者均采用超声造影获得肝脓肿的准确位置、大小及液化程度,脓肿直径1.2~9.1cm,平均(4.9±1.1)cm,动脉快速期增强呈蜂窝状、厚壁环装及肝段一过性,无增强区(液化坏死区)1、2、3处及以上情况;患者治疗后,再行超声检查及病理穿刺复查,68例患者62例病原菌阴性,6例患者检出病原菌12株,1例阿米巴原虫感染,超声常规检查21例患者病灶明显减小或消失,47例患者病灶仍能检出。结论常规超声和超声造影结合能准确诊断肝脓肿,患者经治疗前行超声造影检查可明确脓肿大小、位置及液化程度,为临床治疗提供准确信息。
Objective To analyze and evaluate the application of contrast-enhanced ultrasound in the diagnosis and treatment of liver abscess, and to improve the cognition and treatment of patients with liver abscess. Methods The clinical data of 68 patients with hepatic abscess treated in our hospital from October 2010 to September 2012 were analyzed retrospectively. The changes of ultrasound and pathogenic bacteria before and after treatment were analyzed and analyzed. The role of contrast-enhanced ultrasound in the diagnosis and treatment of hepatic abscess was analyzed. Results Sixty-eight patients were diagnosed pathologically or surgically, 52 were bacterial liver abscesses, of which 63 were pathogenic bacteria, 24 Klebsiella pneumoniae, 18 Escherichia coli, 11 strains of bacteria, 3 strains of Enterococcus faecium, 7 cases of fungal infection, and the other 9 cases of amoeba infection were detected; before treatment ultrasound results, 59 patients were routinely diagnosed by ultrasound ultrasound liver abscess, 9 patients by ultrasound The accuracy of liver abscess was determined by contrast-enhanced ultrasound (CEUS). Abdominal diameter of abscess was 1.2-9.1 cm (average 4.9 ± 1.1 cm). The abscesses of the abscess increased rapidly in honeycomb and thick wall There was no enhancement area (liquefaction necrosis area) at 1, 2, 3 and above. After treatment, patients were reexamined by ultrasound and pathological examination. Sixty-two of the 68 patients were negative with pathogenic bacteria and 6 Twelve strains of pathogens were detected in the patients, one was infected with amoebae. Ultrasound routine examination of 21 patients with lesions significantly reduced or disappeared, and 47 patients were still detected lesions. Conclusion Conventional ultrasound and CEUS can accurately diagnose liver abscess. The patients can confirm the abscess size, location and degree of liquefaction through the ultrasound examination before treatment, providing accurate information for clinical treatment.