Gottschalk U, Ignee A, Dietrich C F
Abteilung Innere Medizin, Maria Heimsuchung Caritas-Klinik Pankow.
Z Gastroenterol. 2010 Nov;48(11):1305-16. doi: 10.1055/s-0029-1245706. Epub 2010 Nov 1.
For many years ultrasound-guided biopsy and drainage has represented a routine part of clinical practice. Percutaneous biopsy and drainage are minimally invasive procedures for sampling tissue or the removal of fluid collections within the body. Differing image guidance techniques for the positioning of the needles/catheters are in use. This is due to the advancement of effectiveness and safety of modern guidance methods. For the management of abscesses, percutaneous drainage is more effective (depending on the size) than percutaneous needle aspiration and is being increasingly used as the first-line treatment. This shift in practice is driven by the preference for low-risk, minimally invasive procedures and thus using surgical interventions only when percutaneous drainage has been unsuccessful. However, the variety of biopsy needles and drainage systems available to the clinician can appear overwhelming. We present a literature review regarding the devices and materials currently available to achieve the most reliable results with the lowest level of complications. With regard to drainage systems, particular considerations include the consistency of fluid, path of access and guidance technique. Although we present comparisons between published studies, it is important to consider that the personal experience of the interventionalist will also have an impact on the device chosen.
多年来，超声引导下活检和引流一直是临床实践的常规组成部分。经皮活检和引流是用于获取组织样本或清除体内液体聚集物的微创手术。目前正在使用不同的图像引导技术来定位针/导管。这是由于现代引导方法在有效性和安全性方面的进步。对于脓肿的处理，经皮引流（取决于大小）比经皮针吸更有效，并且越来越多地被用作一线治疗方法。这种实践上的转变是由对低风险、微创手术的偏好驱动的，因此仅在经皮引流不成功时才使用手术干预。然而，临床医生可获得的活检针和引流系统种类繁多，可能会让人应接不暇。我们对目前可用的设备和材料进行了文献综述，以实现最可靠的结果并将并发症降至最低水平。关于引流系统，特别需要考虑的因素包括液体的稠度、进入路径和引导技术。尽管我们对已发表的研究进行了比较，但重要的是要考虑到介入医生的个人经验也会对所选设备产生影响。
