超声引导下经皮肝穿刺抽脓法与置管引流法治疗2型糖尿病并发肝脓肿的疗效对比

肝脏 ›› 2025, Vol. 30 ›› Issue (12): 1710-1713.

超声引导下经皮肝穿刺抽脓法与置管引流法治疗2型糖尿病并发肝脓肿的疗效对比

徐腾云, 朱美娣, 阚晓纯, 陈超波

214011 无锡无锡市锡山人民医院,东南大学附属中大医院无锡分院超声医学科(徐腾云,朱美娣,阚晓纯),普外科(陈超波)

收稿日期:2025-03-09 发布日期:2026-02-10
通讯作者: 陈超波,Email:13337914425@163.com
基金资助:
无锡市卫生健康委中青年拔尖人才资助计划(HB2023116)

Comparison of the efficacy between ultrasound-guided percutaneous liver abscess aspiration and catheter drainage in treating type 2 diabetes mellitus complicated with liver abscess

XU Teng-yun¹, ZHU Mei-di¹, KAN Xiao-chun¹, CHEN Chao-bo²

1. Department of Ultrasound Medicine, Xishan People's Hospital, Wuxi Branch of Southeast University Affiliated Zhongda Hospital, Wuxi 214011, China;
2. Department of General Surgery, Xishan People's Hospital, Wuxi Branch of Southeast University Affiliated Zhongda Hospital, Wuxi 214011, China

Received:2025-03-09 Published:2026-02-10
Contact: CHEN Chao-bo,Email:13337914425@163.com

摘要/Abstract

摘要： 目的比较超声引导下经皮肝穿刺抽脓法与置管引流法治疗2型糖尿病(T2DM)并发肝脓肿的疗效。方法纳入2021年6月至2025年3月我院收治的T2DM并发肝脓肿患者83例,根据治疗方法分为观察组(n=41,超声引导下经皮肝穿刺抽脓法)、对照组(n=42,置管引流法),比较两组围手术期指标、治疗前后肝功能、白细胞(WBC)、炎症细胞因子等指标,统计两组并发症并进行比较。结果观察组体温恢复时间、WBC恢复正常时间、肝区疼痛消失时间及脓腔消失时间为(3.0±1.2)d、(4.3±1.3)d、(1.2±0.5)d及(7.2±1.5)d,均显著短于对照组[(3.7±1.4)d、(6.2±1.0)d、(1.5±0.6)d及(10.5±2.8)d),P<0.05]。与治疗前比,治疗一周两组肝功能指标显著改善(P<0.05),而治疗前和治疗一周两组肝功能指标差异无统计学意义(P>0.05)。与治疗前比,治疗1周两组炎性指标均显著降低(P<0.05),而治疗前和治疗1周两组炎性指标差异未见统计学意义(P>0.05)。两组并发症包括出血和血肿形成、切口感染、胆漏和胆汁性腹膜炎及气胸,观察组并发症发生为3例(7.3%),显著低于对照组[10例(23.8%),P<0.05]。结论在严格掌握适应证的前提下,超声引导下经皮肝穿刺抽脓法相比置管引流法能更快速缓解临床症状、促进脓腔消失,且具有更低的并发症发生率。

关键词: 肝脓肿, 2型糖尿病, 超声引导下经皮肝穿刺抽脓法

Abstract: Objective To compare the efficacy of ultrasound-guided percutaneous liver abscess aspiration versus catheter drainage in treating type 2 diabetes mellitus (T2DM) complicated with liver abscess. Methods A total of 83 patients with T2DM complicated by liver abscess admitted to our hospital between June 2021 and March 2025 were divided into an observation group (n=41, aspiration) and a control group (n=42, drainage) based on the intervention. Perioperative indicators, liver function, WBC counts, inflammatory cytokines, and complications in our study were compared between two groups. Results The observation group showed significantly shorter recovery times of body temperature (3.4±1.2) days, WBC normalization (4.3±1.3) days, liver pain resolution (1.2±0.5) days, and abscess cavity disappearance (7.2±1.5) days compared to the control group [(3.7±1.4) days, (6.2±1.0) days, (1.5±0.6) days, and (10.5±2.8) days, respectively; P<0.05]. After 1 week of treatment, liver function were improved significantly in both groups (P<0.05), but no intergroup differences were observed in ALT, AST, or Alb levels before or after treatment (P>0.05). Similarly, WBC, IL-6, PCT, and TNF-α levels decreased significantly post-treatment (P<0.05), with no intergroup differences (P>0.05). Complications (e.g., hemorrhage, hematoma, incision infection, bile leakage, biliary peritonitis, pneumothorax) occurred in 3 cases (7.3%) in the observation group were significantly lower than the control group [10 cases (23.8%), P<0.05]. Conclusion Ultrasound-guided percutaneous liver puncture and pus aspiration can relieve clinical symptoms more quickly and promote the disappearance of pus cavity, and has a lower incidence of complications than catheter drainage.

Key words: Liver abscess, Type 2 diabetes mellitus, Ultrasound-guided percutaneous liver abscess aspiration

徐腾云, 朱美娣, 阚晓纯, 陈超波. 超声引导下经皮肝穿刺抽脓法与置管引流法治疗2型糖尿病并发肝脓肿的疗效对比[J]. 肝脏, 2025, 30(12): 1710-1713.

XU Teng-yun, ZHU Mei-di, KAN Xiao-chun, CHEN Chao-bo. Comparison of the efficacy between ultrasound-guided percutaneous liver abscess aspiration and catheter drainage in treating type 2 diabetes mellitus complicated with liver abscess[J]. Chinese Hepatolgy, 2025, 30(12): 1710-1713.

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