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目的探讨腹膜腔的解剖、生理和腹膜脓肿的CT诊断及介入治疗。方法分析36例腹膜腔脓肿的CT表现和介入治疗方法。结果7例脾窝脓肿,3例小网膜囊脓肿,8例兰尾周围脓肿,4例结肠旁沟脓肿,5例盆腔脓肿和9例胰周间隙脓肿CT均表现为低密度的囊性包块,与周围组织境界请楚,囊壁强化明显,在11例腹膜腔脓肿内可见小气泡影。36例腹膜腔脓肿中,21例有腹部手术和术后发热史,13例有急性胰腺炎或急性兰尾炎、盆腔炎的病史,2例有腹部外伤病史。36例均有高热、腹痛、WBC升高等临床症象,其中30例经抗炎治疗后脓肿不吸收。行CT导引下脓肿穿刺、抽脓冲洗、放置引流管后,脓肿及系列症状逐消失。结论CT能清晰地显示腹膜腔脓肿的部位、大小、形态、与周围结构的关系,CT导引下的脓肿穿刺引流对其治疗有重要价值。
Objective To investigate peritoneal anatomy, physiology and peritoneal abscess CT diagnosis and interventional treatment. Methods 36 cases of peritoneal abscess CT performance and interventional treatment. Results Seven cases of splenic abscess, three cases of minor retinal cyst abscess, eight cases of caudal abscess, four cases of colonic canal abscess, five cases of pelvic abscess and nine cases of peripancreatic abscess showed low-density cystic sac Block, and the surrounding tissue please Chu, strengthen the obvious wall, in 11 cases of peritoneal abscess visible small bubbles. Of the 36 cases of peritoneal abscess, 21 had abdominal surgery and postoperative fever, 13 had a history of acute pancreatitis or acute maladyosis and pelvic inflammatory disease, and 2 had a history of abdominal trauma. Thirty-six patients had clinical symptoms such as high fever, abdominal pain and elevated WBC, of which 30 were not absorbed after anti-inflammatory treatment. Under CT guided abscess puncture, purulent flushing, drainage tube placement, abscess and symptoms disappear. Conclusion CT can clearly show the location, size and shape of peritoneal abscess and its relationship with the surrounding structures. CT-guided abscess drainage is of great value for its treatment.