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目的对比超声引导下肝脓肿经皮穿刺针(PTC)抽吸与超声引导下置管引流的疗效。方法 2014年1月—2015年12月选取在湖州市中心医院超声科就诊的40例细菌性肝脓肿患者,采用随机数字表将40例细菌性肝脓肿患者分为2组,其中A组患者(20例)在超声引导下用PTC针行单纯抽吸术,B组患者(20例)在超声引导下行置管引流术。观察2组一次性治愈率、体温恢复正常时间、疼痛减弱时间、脓肿腔消失时间及住院治疗时间,随访有无复发及并发症发生情况等。结果 B组20例患者治愈,有效率为100%;A组13例患者一次穿刺治愈,有效率为65%,4例2~5 d后行第2次穿刺后治愈,其余3例在2次穿刺后仍有较大脓腔,行置管引流术后治愈。2组患者的有效率比较差异有统计学意义(P<0.05)。A组体温恢复正常时间、疼痛减弱时间、脓肿消失时间及住院时间分别为(3.0±0.6)d、(2.5±0.6)d、(12.5±3.5)d、(15.6±4.0)d,均长于B组的(2.0±0.5)d、(1.2±0.5)d、(7.2±2.0)d、(10.3±3.0)d,差异有统计学意义(P<0.05)。A组并发症发生率为40.0%(8/20),B组并发症发生率为5.0%(1/20),2组并发症比较差异有统计学意义(χ~2=5.161,P<0.05)。结论细菌性肝脓肿经超声引导下置管引流管治疗,能有效提高患者治疗效果,减轻患者疼痛感,缩短患者治疗时间,效果显著,值得推广。
Objective To compare the curative effect of ultrasound-guided percutaneous needle aspiration (PTC) and ultrasound-guided catheter drainage. Methods From January 2014 to December 2015, 40 patients with bacterial liver abscess treated in Department of Ultrasound, Huzhou Central Hospital were enrolled and 40 patients with bacterial liver abscess were divided into two groups according to the random number table. Patients in group A 20 patients underwent PTC aspiration under ultrasound guidance. Patients in group B (20 patients) underwent catheterization under ultrasound guidance. Two groups were observed one-time cure rate, body temperature recovery time, pain reduction time, disappearance of abscess cavity and hospitalization time, follow-up with or without recurrence and complications. Results In group B, 20 patients were cured and the effective rate was 100%. In group A, 13 patients were cured by one puncture. The effective rate was 65%. After 4 to 5 days, the second puncture was cured and the remaining 3 patients were treated twice After puncture there is still a larger abscess, drainage catheter drainage line cure. The effective rate of the two groups was statistically significant difference (P <0.05). The time of recovery of body temperature, the time of pain reduction, the disappearance time of abscess and hospital stay in group A were (3.0 ± 0.6) days and (2.5 ± 0.6) days and (12.5 ± 3.5) days and (15.6 ± 4.0) days, respectively, (2.0 ± 0.5) d, (1.2 ± 0.5) d, (7.2 ± 2.0) d and (10.3 ± 3.0) d respectively. The difference was statistically significant (P <0.05). The incidence of complications in group A was 40.0% (8/20), the incidence of complications in group B was 5.0% (1/20), there was significant difference between the two groups (χ ~ 2 = 5.161, P <0.05 ). Conclusion Bacterial liver abscess under the guidance of ultrasound-guided drainage tube can effectively improve the therapeutic effect of patients, reduce pain in patients and shorten the treatment time of patients, the effect is significant and worth promoting.