Zerem Enver, Hadzic Amir
Interventional Ultrasonography Department, University Clinical Center, Trnovac bb, Tuzla, Bosnia and Herzegovina.
AJR Am J Roentgenol. 2007 Sep;189(3):W138-42. doi: 10.2214/AJR.07.2173.
The purpose of this study was to determine the effectiveness of percutaneous catheter drainage (PCD) and to compare PCD with percutaneous needle aspiration in the management of liver abscess.
Sixty patients with pyogenic liver abscess were randomly assigned to two groups in a prospective study. Antibiotics were administered for 10 days, starting the day of the beginning of percutaneous treatment. One group was treated with sonographically guided PCD and the other group with repeated percutaneous needle aspiration. Percutaneous needle aspiration was attempted a maximum of three times. Lack of response to the third aspiration was considered failure of treatment; these patients were treated with PCD but were not included in the PCD group for analysis. Patient demographics, duration of hospital stay, treatment outcome, and complications were analyzed.
Percutaneous needle aspiration was successful in 20 (67%) of the 30 patients after one (n = 12), two (n = 7), or three (n = 1) aspirations. PCD was curative in all 30 patients after one (n = 24) or two (n = 6) procedures. All abscesses 50 mm or less in longest diameter were successfully managed, 10 by percutaneous needle aspiration and 12 by PCD. None of patients in the percutaneous needle aspiration group with multiloculated abscesses (n = 5) was successfully treated. Hospital stay did not differ significantly between the groups. There were no complications related to the procedure.
PCD is more effective than percutaneous needle aspiration in the management of liver abscess. Percutaneous needle aspiration can be used as a valid alternative for simple abscesses 50 mm in diameter or smaller.
本研究旨在确定经皮导管引流（PCD）的有效性，并将PCD与经皮针吸术在肝脓肿治疗中的效果进行比较。
在一项前瞻性研究中，将60例化脓性肝脓肿患者随机分为两组。从经皮治疗开始日起给予抗生素治疗10天。一组采用超声引导下的PCD治疗，另一组采用反复经皮针吸术治疗。经皮针吸术最多尝试3次。对第三次针吸无反应被视为治疗失败；这些患者采用PCD治疗，但不纳入PCD组进行分析。分析患者的人口统计学资料、住院时间、治疗结果及并发症。
30例患者中，经1次（n = 12）、2次（n = 7）或3次（n = 1）针吸后，20例（67%）经皮针吸术成功。30例患者经1次（n = 24）或2次（n = 6）PCD治疗均治愈。所有最长直径50 mm及以下的脓肿均成功处理，10例通过经皮针吸术，12例通过PCD。经皮针吸术组中，5例多房性脓肿患者均未成功治疗。两组住院时间差异无统计学意义。未出现与操作相关的并发症。
在肝脓肿治疗中，PCD比经皮针吸术更有效。经皮针吸术可作为直径50 mm或更小的单纯脓肿的有效替代方法。
