Martínek A, Hrabovský V, Klvana P
Interní klinika FNsP, Ostrava.
Vnitr Lek. 2003 Aug;49(8):630-6.
The authors deal with the problem of application of a therapeutic fine needle aspiration puncture in abscesses and other purulent foci in organs of abdominal cavity and retroperitoneum. The treatment using this method under continuing antibiotic therapy has been used in 60 patients (40 men, 20 women), 25 of them suffering from liver abscesses, 28 other from purulent foci of pancreas and seven patients from purulent foci of the kidney. In most patients there were solitary foci (43 persons). The total volume of the evacuated pus was higher than 20 ml in most patients (52), being even more than 100 ml in 2 patients. No relation ship was found among the number of foci, their volume and efficiency of the treatment. The average number of punctures until the abscesses and other purulent foci were healed up was 2.76 in the liver, 2.5 in pancreas and 1.1 in the kidney. The efficiency of therapy was higher in liver abscesses (96%), in purulent foci of pancreas (82%) and lower in the kidney abscesses (57%). The higher efficiency in the purulent foci of pancreas was probably influenced by predominant representation by infected pseudocysts in this group. The lower average number of punctures until the abscesses were healed up and the lower success in the kidney were influenced by a more radical approach of urologists who, having made the first evacuation puncture, performed a radical operation intervention. The complications were encountered in 9.5% of all punctures, being always insignificant. The results obtained demonstrated the contribution of aimed therapeutic aspiration puncture in the therapy of purulent foci of parenchymal organs of abdominal cavity and retroperitoneum as compared with surgical treatment. The advantage of the applied method in the therapy of purulent foci of the liver and pancreas may be seen in the higher success rate, low invasiveness and a low risk of complications together with a low financial cost and wide availability.
作者探讨了治疗性细针穿刺抽吸术在腹腔和腹膜后器官脓肿及其他化脓病灶中的应用问题。在持续抗生素治疗的情况下，该方法已用于60例患者（40例男性，20例女性），其中25例患有肝脓肿，28例患有胰腺化脓病灶，7例患有肾化脓病灶。大多数患者（43人）为单个病灶。大多数患者（52例）抽出的脓液总量超过20毫升，2例患者甚至超过100毫升。未发现病灶数量、体积与治疗效果之间存在关联。肝脓肿、胰腺脓肿及肾脓肿愈合前的平均穿刺次数分别为2.76次、2.5次和1.1次。肝脓肿的治疗有效率较高（96%），胰腺化脓病灶的有效率为82%，肾脓肿的有效率较低（57%）。胰腺化脓病灶的有效率较高可能是因为该组中感染性假性囊肿占主导。肾脓肿愈合前的平均穿刺次数较少以及成功率较低，是由于泌尿外科医生采取了更激进的方法，在首次进行抽吸引流穿刺后，便实施了根治性手术干预。所有穿刺中有9.5%出现并发症，但均不严重。所获结果表明，与手术治疗相比，靶向治疗性穿刺抽吸术在腹腔和腹膜后实质器官化脓病灶的治疗中具有重要作用。该方法在肝和胰腺化脓病灶治疗中的优势体现在成功率较高、侵袭性低、并发症风险低、经济成本低且易于实施。
