摘要
目的探讨细菌性肝脓肿腹腔镜切开引流术和经皮穿刺引流术的适应证及疗效。方法对外科处理的83例肝脓肿患者的临床资料进行回顾性分析,比较细菌性肝脓肿腹腔镜切开引流术与经皮穿刺引流术的疗效。结果两组患者年龄、性别、脓肿大小、数量、病程、术前白细胞计数、清蛋白、空腹血糖水平比较,差异均无统计学意义(P>0.05)。腹腔镜组手术时间较穿刺引流组明显延长,差异有统计学意义(P<0.05);两组体温恢复正常时间比较,差异无统计学意义(P>0.05);腹腔镜组白细胞恢复时间及住院时间较穿刺引流组明显缩短,差异有统计学意义(P<0.05);腹腔镜组较穿刺引流组治愈率明显升高,复发率明显降低,差异均有统计学意义(P<0.05)。两组患者经治疗后均无大出血、腹膜炎、腹腔脏器损伤、胆瘘等严重并发症发生。结论腹腔镜肝脓肿切开引流术和经皮肝脓肿穿刺引流术均是微创治疗细菌性肝脓肿的有效手段,前者操作更加简单安全,后者治疗更彻底。把握二者的适应证尤其重要。
Objective To explore the indications and curative effects of laparoscopic drainage and percutaneous tran- shepatic drainage in treating pyogenic liver abscess. Methods Data from 83 patients with pyogenic liver abscess after surgical ma- nipulation were analyzed retrospectively, and the outcomes of laparoseopic drainage were compared with those of percutaneous transhepatic drainage. Results No significant differences were noted when age, gender, size of abscess, quantity of abscess, course of disease, preoperative lencocyte count, albumin level and fasting blood sugar level were compared between the two groups （P 〉 0.05 ） . Operating time Of the laparoseopic drainage group was notably longer than the percutaneous transhepatie drainage group with statistically significant difference （P 〈 0. 05 ） . Time of body temperature restoration was not statistically sig- nificant between the two groups （ P 〉 0. 05 ） . Time of white blood cell （WBC） restoration and the hospital stay length of the lap- aroscopie drainage group were notably shorter than the pereutaneous transhepatie drainage group with statistically significant differ- ences （P 〈 O. 05 ） . Cure rates were higher, while recurrence rates were lower, among the laparoscopic drainage group compared with the pereutaneous transhepatic drainage group with statistically significant differences （ P 〈 0. 05 ） . No serious complications including hemorrhea, peritonitis, damage of celiac organ and biliary fistula occurred after treatment in both groups. Conclusion Percutaneous transhepatie drainage and laparoscopie drainage are efficient alternatives for treatment of pyogenic liver ab- scess. Manipulation of the former is more easy and safety, while the latter offers more thorough therapy. It is of great significance to differentiate the indications.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第26期3056-3058,共3页
Chinese General Practice
