关键词: 肝脓肿, 细菌性, 射频消融术, 治疗时间, 住院时间

Abstract: Objective To observe the effect of radiofrequency ablation at different time on the recovery of refractory bacterial liver abscess. Methods A total of 88 patients with refractory bacterial liver abscess admitted to our hospital from January 2017 to January 2021 were selected. All the patients received radiofrequency ablation in our hospital, and were divided into group A and group B according to the different time between the onset of the disease and the treatment of radiofrequency ablation. The time from onset to radiofrequency ablation in group A (n=45) was ≤ 72 h, and that in group B (n=43) was > 72 h. Both groups returned to hospital for reexamination 3 months after surgery to evaluate the clinical efficacy of both groups. Blood samples were collected preoperatively and 3 months after operation, and tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected by enzyme linked immunosorbent assay. Finally, the differences between the two groups in operative time, temperature normalization time, white blood cell count normalization time, length of hospital stay, hospitalization cost and incidence of postoperative complications during hospitalization were compared. Results There was no significant difference in total effective rate between the two groups (93.3% VS 93.0%, P>0.05). In group A, the operation time, temperature normalization time, white blood cell count normalization time, hospitalization time and hospitalization cost were (51.4±9.3) min, (3.5±0.8) d, (5.4±0.9) d, (7.8±1.5) d, (3.4±0.5) ten thousand yuan, respectively. In group B, those were (59.7±10.8) min, (4.9±1.4) d, (6.8±1.4) d, (9.2±2.0) d, (3.9±0.7) ten thousand yuan, respectively. The operation time, temperature normalization time, white blood cell count normalization time and hospitalization time of group A were significantly shorter than those of group B (P<0.05), and the hospitalization cost of group A was significantly less than that of group B (P<0.05). The preoperative levels of TNF-α, IL-6 and IL-8 in group A were (74.5±20.4) pg/mL, (192.4±40.5) pg/mL, and (90.4±15.6) pg/mL, respectively, and the postoperative levels of those were (42.1±12.7) pg/mL, (71.7±21.0) pg/mL, (54.1±11.3) pg/mL, respectively. The preoperative levels of TNF-α, IL-6 and IL-8 in group B were (75.0±20.9) pg/mL, (192.0±41.3) pg/mL, and (90.8±15.1) pg/mL, respectively, the postoperative levels were (42.8±13.0) pg/mL, (72.0±21.8) pg/mL, and (53.9±12.9) pg/mL, respectively. There was no significant difference in the preoperative levels of TNF-α, IL-6 and IL-8 between the two groups (P>0.05). Compared with preoperation, the levels of TNF-α, IL-6 and IL-8 in both groups were significantly decreased after operation (P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (24.4% VS 23.3%, P>0.05). Conclusion Radiofrequency ablation is safe and effective in patients with refractory bacterial liver abscess. Compared with patients that the time from onset to radiofrequency ablation > 72 h, patients that the aforementioned time ≤ 72 h have advantages of faster postoperative recovery and less hospitalization cost after treatment.

Key words: Liver abscess, Bacterial, Radiofrequency ablation, Treatment time, The length of time