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目的:总结分析化脓性肝脓肿穿刺引流时间及其影响因素。方法:回顾性分析近5年来行穿刺引流治疗的肝脓肿患者临床资料。评价临床疗效,探讨引流时间及其影响因素。采用统计学方法包括T检验和Fisher’s确切检验。统计学软件采用SPSS 16.0。结果:共有218例患者纳入研究。18例(8.25%)患者存在感染性休克,22例(10.09%)患者存在血行感染性并发症。156例(71.56%)血细菌培养或脓汁细菌培养阳性。致病菌占首位的为肺炎克雷伯杆菌(67.94%)。经皮穿刺引流术治疗肝脓肿的临床成功率96.33%,平均带管引流时间(29.24±9.27)天。影响带管引流时间的因素为:多房(P=0.018)、实性(P=0.013)、合并肝胆胰恶性肿瘤(P<0.001)。结论:经皮穿刺引流治疗肝脓肿临床疗效显著,多房、实性及合并肝胆胰恶性肿瘤是影响引流时间的主要因素。
Objective: To summarize and analyze the time of puncture and drainage of suppurative liver abscess and its influencing factors. Methods: The clinical data of patients with liver abscess treated by puncture and drainage in the past 5 years were retrospectively analyzed. Evaluation of clinical efficacy, to explore the drainage time and its influencing factors. Statistical methods include T-test and Fisher’s exact test. Statistical software using SPSS 16.0. Results: A total of 218 patients were included in the study. Septic shock occurred in 18 patients (8.25%), and blood-borne complications occurred in 22 patients (10.09%). 156 cases (71.56%) of blood bacterial culture or pus bacterial culture positive. The first pathogen was Klebsiella pneumoniae (67.94%). The clinical success rate of percutaneous drainage for the treatment of liver abscess was 96.33%, with an average drainage time of (29.24 ± 9.27) days. The factors affecting the drainage time were: multiple rooms (P = 0.018), solidity (P = 0.013), combined hepatobiliary and pancreatic cancer (P <0.001). Conclusion: The clinical effect of percutaneous drainage for the treatment of liver abscess is remarkable. The multi-chamber, solid and combined hepatobiliary and pancreatic cancer are the main factors affecting the drainage time.