Gervais Debra A, Ho Chie Hee, O'Neill Mary J, Arellano Ronald S, Hahn Peter F, Mueller Peter R
Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA.
AJR Am J Roentgenol. 2004 Feb;182(2):463-6. doi: 10.2214/ajr.182.2.1820463.
We undertook this study to determine the incidence and results of repeated (secondary) percutaneous abscess drainage performed on recurrent abscesses after successful initial (primary) percutaneous abscess drainage.
Imaging studies from patients who underwent multiple drainages were reviewed to define a cohort of patients who underwent secondary percutaneous abscess drainage after successful initial percutaneous abscess drainage of the same abscess. Medical records of these patients were then reviewed to assess the results of secondary percutaneous abscess drainage.
Forty-five abscesses in 43 patients required secondary percutaneous abscess drainage. Twenty-four of the 43 patients avoided surgery. Secondary percutaneous abscess drainage was successful in evacuating the abscess cavity in 39 (91%) of 43 patients. Duration of drainage and time until recurrence were not significant predictors for avoiding surgery. Mean duration of secondary percutaneous abscess drainage was significantly longer than mean duration of primary percutaneous abscess drainage, but duration of secondary percutaneous abscess drainage (25 vs 14 days, respectively; p = 0.007) did not differ significantly between patients who ultimately required surgery and those who did not (17 vs 11 days, respectively; p = 0.10). Time to recurrence ranged from 2 days to 1 year (mean, 51 days).
After successful primary percutaneous abscess drainage, secondary percutaneous abscess drainage of recurrent abscesses succeeded in evacuating the abscess cavity in most patients, and surgery was avoided by slightly more than half. Patients with postoperative abscesses were significantly more likely to avoid surgery (p = 0.008), whereas patients with pancreatic abscesses were significantly more likely to require it (p = 0.03).
我们开展这项研究，以确定在首次（原发性）经皮脓肿引流成功后，对复发性脓肿进行重复（继发性）经皮脓肿引流的发生率及结果。
回顾接受多次引流患者的影像学研究，以确定一组在同一脓肿首次经皮脓肿引流成功后接受继发性经皮脓肿引流的患者。然后查阅这些患者的病历，以评估继发性经皮脓肿引流的结果。
43例患者中的45个脓肿需要进行继发性经皮脓肿引流。43例患者中有24例避免了手术。继发性经皮脓肿引流在43例患者中的39例（91%）成功排空了脓肿腔。引流持续时间和复发时间不是避免手术的显著预测因素。继发性经皮脓肿引流的平均持续时间明显长于原发性经皮脓肿引流的平均持续时间，但继发性经皮脓肿引流的持续时间（分别为25天和14天；p = 0.007）在最终需要手术的患者和未手术的患者之间无显著差异（分别为17天和11天；p = 0.10）。复发时间从2天到1年不等（平均51天）。
在原发性经皮脓肿引流成功后，复发性脓肿的继发性经皮脓肿引流在大多数患者中成功排空了脓肿腔，略多于一半的患者避免了手术。术后脓肿患者显著更有可能避免手术（p = 0.008），而胰腺脓肿患者显著更有可能需要手术（p = 0.03）。
