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目的:探讨肝脓肿经皮穿刺介入引流的临床应用及术后拔管的时间窗。方法:回顾分析1999年11月-2007年11月62例肝脓肿住院患者,按照治疗方法不同分为介入治疗组(介入组,32例)和外科治疗组(外科组,30例)。介入组在DSA引导下行肝脓肿穿刺引流,抽吸脓液、冲洗脓腔,并留置肝外引流管作持续冲洗及引流;外科组采用外科手术切开引流并留置引流管。结果:介入组的平均住院时间(11.29±1.64)d、留管时间(8.08±1.29)d、并发症0例,与外科组比较,两组差异有统计学意义(P<0.05),而平均退热时间及有效率方面两组差异无统计学意义(P>0.05)。结论:肝脓肿的介入治疗对肝组织的损伤较小,并发症少,操作简单,术后拔除外引流管的时间窗以选择在无发热后3d为宜。
Objective: To investigate the clinical application of percutaneous drainage of liver abscess and the time window of postoperative extubation. Methods: A retrospective analysis of 62 hospitalized patients with liver abscess from November 1999 to November 2007 was divided into intervention group (intervention group, 32 cases) and surgical treatment group (surgical group, 30 cases) according to different treatment methods. The intervention group underwent hepatic abscess drainage, suctioning pus, flushing abscess, and indwelling extrahepatic drainage tube for continued irrigation and drainage. The surgical group underwent surgical incision and drainage and indwelling drainage tube. Results: The average length of stay (11.29 ± 1.64) days, the duration of catheterization (8.08 ± 1.29) days and the complication in the intervention group were significantly different from those in the surgical group (P <0.05) There was no significant difference between the two groups in the antipyretic time and the effective rate (P> 0.05). Conclusion: Interventional treatment of liver abscess has less damage to the liver tissue, less complications and simple operation. It is advisable to select the time window of the external drainage tube after the operation for 3d in the absence of fever.