超声引导下经皮肝穿刺抽脓法和置管引流法治疗细菌性肝脓肿患者的疗效分析

摘要/Abstract

摘要： 目的分析超声引导下经皮肝穿刺抽脓法与置管引流术对细菌性肝脓肿患者治疗疗效的影响。方法前瞻性收录 2020 年 10 月至 2023 年 4 月期间我院诊治的 80 例细菌性肝脓肿患者作为研究对象。入组后,按照随机数字方法设置为对照组(34例,超声引导下经皮肝穿刺抽脓法)、观察组(46例,超声引导下经皮肝穿刺置管引流法)。比较2组临床疗效、症状改善情况、炎性指标、并发症发生率。结果临床疗效比较,对照组88.2%低于观察组91.3%;对照组体温恢复时间、疼痛消失时间、脓肿消失时间分别为(3.0±0.7)d、(2.8±0.6)d、(12.6±2.0)d,观察组体温恢复时间、疼痛消失时间、脓肿消失时间分别为(3.1±0.8)d、(2.7±0.6)d、(12.8±2.2)d;治疗后对照组血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平分别为(21.9±3.4)ng/mL、(25.3±3.9)ng/mL、(8.6±1.5)ng/mL,高于观察组(22.1±3.5)ng/mL、(25.7±3.9)ng/mL、(8.9±1.6)ng/mL;对照组并发症总发生率为17.7%,观察组并发症总发生率为20.6%,差异均无统计学意义(P>0.05)。结论超声引导下经皮肝穿刺抽脓法和置管引流法治疗细菌性肝脓肿均可取得良好疗效,有助于改善临床症状,降低炎症因子水平,安全性好,临床可根据患者情况进行选择。

关键词: 细菌性肝脓肿, 超声引导, 穿刺抽脓, 置管引流

Abstract: Objective To analyze the effects of ultrasound-guided percutaneous hepatic puncture for pus extraction and tube placement for drainage on the therapeutic efficacy of patients with bacterial liver abscesses. Methods 80 patients with bacterial liver abscesses treated in our hospital from 2020.10 to 2023.4 were enrolled in this study, prospectively. Patients were divided into a control group (34 cases, ultrasound-guided percutaneous hepatic puncture for pus extraction) and an observation group (46 cases, ultrasound-guided percutaneous hepatic puncture for drainage) according to the randomized numerical method. Clinical efficacy, symptom improvement, inflammatory indicators, and complication rates were compared between the 2 groups. Results Clinical efficacy in the control group was 88.2% , lower than 91.3% in the observation group; the recovery time of body temperature, the disappearance time of pain, and the disappearance time of abscess were (3.0±0.7) d, (2.8±0.6) d, and (12.6±2.0) d, respectively, as for the observation group, the recovery time of body temperature, the disappearance time of pain, and the disappearance time of abscess were (3.1±0.8) d, (2.7±0.6) d, and (12.8±2.2) d, respectively; the serum interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) levels in the control group after treatment were (21.9±3.4) ng/mL, (25.3±3.9) ng/mL, (8.6±1.5) ng/mL, respectively, higher than (22.1±3.5) ng/mL, (25.7±3.9) ng/mL, and (8.9±1.6) ng/mL in the observation group; the total complication rate of the control group was 17.7% , and the total complication rate of the observation group was 20.6%, there was no difference between two groups (P>0.05). Conclusion Ultrasound-guided percutaneous hepatic puncture to extract pus and tube drainage exhibited good efficacy in the treatment of patients with bacterial liver abscess, which can improve clinical symptoms, reduce the level of inflammatory factors, and have good safety, worthy to be selected as clinical treament according to the patient′s condition.

Key words: Bacterial liver abscess, Ultrasound guidance, Puncture aspiration for pus, Catheterization and drainage

杨正芳, 漆家高, 张福群, 王元. 超声引导下经皮肝穿刺抽脓法和置管引流法治疗细菌性肝脓肿患者的疗效分析[J]. 肝脏, 2025, 30(7): 979-982.

YANG Zheng-fang, QI Jia-gao, ZHANG Fu-qun, WANG Yuan. Analysis of therapeutic effects of ultrasound-guided percutaneous liver puncture and catheterization drainage in the treatment of patients with bacterial liver abscess[J]. Chinese Hepatolgy, 2025, 30(7): 979-982.

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