摘要
目的总结老年性细菌性肝脓肿的多层螺旋CT（MSCT）影像学特征及其治疗方法。方法回顾性分析2001年3月至2014年2月在灌南县中医院确诊为老年性细菌性肝脓肿的42例患者的临床资料,总结MSCT影像学特征及临床治疗特点。组间比较采用t检验。结果 42例患者中,37例病灶位于肝右叶,5例位于肝左叶;33例为单发病灶,9例病灶表现为多房或蜂窝状征象。MSCT平扫结果示,病灶均表现为较正常肝组织低的低密度灶,CT值约6~40 Hu;动脉期：39例病灶边缘环状强化,3例病灶边缘无强化。内科保守治疗15例,穿刺引流27例。15例行内科保守治疗的患者脓腔直径（3.7±2.1）cm,发热时间为（11.7±4.1）d,平均住院（22.6±5.3）d;27例行穿刺引流治疗的患者脓腔直径（6.3±2.8）cm,发热时间为（7.1±2.2）d,平均住院（13.7±3.1）d,两组比较差异均有统计学意义（P值分别为0.021、0.026、0.006）。结论 MSCT检查能够准确显示脓肿位置、形态,结合患者病史可做出正确的诊断。B超或CT引导下穿刺引流治疗是一种有效、微创、安全的治疗方法,可有效控制发热,加快老年患者恢复。
Objective To review the multislice computed tomography （MSCT）characteristics and treatment of pyogenic liver abscess in elderly patients.Methods A retrospective analysis was performed on the clinical data of 42 elderly patients who were diagnosed with pyo-genic liver abscess in our hospital from March 2001 to February 2014.The MSCT characteristics and clinical treatment of this disease were reviewed.Comparison between two groups was made by t test.Results Among the 42 patients,37 had the liver abscess in the right lobe, and 5 in the left lobe;33 had single lesions,and 9 had grid-or honeycomb-like lesions.MSCT scan showed that all lesions had a lower density compared with normal hepatic tissues,and the CT values were approximately 6 -40 Hu.In the arterial phase,39 patients had le-sions with peripheral rim enhancement,and 3 had no edge enhancement.Conservative treatment was given to 15 patients,among whom the diameter of abscess was 3.7 ±2.1 cm,the duration of fever was 11.7 ±4.1 d,and the average hospital stay was 22.6 ±5.3 d.Percutane-ous drainage was performed in 27 patients,among whom the diameter of abscess was 6.3 ±2.8 cm,the duration of fever was 7.1 ±2.2 d, and the average hospital stay was 13.7 ±3.1 d.There were significant differences in the diameter of abscess,the duration of fever,and the length of hospital stay between the two groups （P=0.021,0.026,and 0.006,respectively）.Conclusion MSCT can accurately reveal the location and morphology of abscess,and correct diagnosis can be made in combination with the patient＆#39;s medical history.Drainage guided by ultrasound or CT is an effective,minimally invasive,and safe treatment for controlling fever and promoting fast recovery in the elderly.
出处
《临床肝胆病杂志》
CAS
2015年第1期103-106,共4页
Journal of Clinical Hepatology
