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[经皮腹腔脓肿引流术]

[Percutaneous drainage of abdominal abscesses].

作者信息

Fernández M, Ortega D, Darrás A, Gallardo S, Yarmuch J

机构信息

Departamento de Cirugía, Hospital Clínico Universidad de Chile, Santiago.

出版信息

Rev Med Chil. 1990 Jul;118(7):772-6.

PMID:2131526
Abstract

Percutaneous drainage has been widely accepted as the preferred treatment for abdominal abscess. Indications have been clarified recently and the absence of a secure route is the only absolute contraindication. We performed this procedure in 65 patients with abdominal abscess at different locations: liver 27, subphrenic 33, lesser cavity 3 and perirenal 3. Overall success rate was 85%, with 89% for liver and 88% for the subphrenic location. Six patients died of multisystemic failure even though the abscess was properly drained. Four patients were operated on for persistent abscess. A pancreatic fistula was shown in 1 and a peritoneal hydatid cyst was the original lesion in the other. Pneumothorax occurred in 5 patients requiring drainage in 2. Two other patients developed hydro-pneumothorax and empyema, that was drained. The overall complication rate was 14%. Thus, percutaneous drainage is a simple and highly successful treatment for abdominal abscess. Results are influenced by the accuracy of diagnosis and a proper selection of patients.

摘要

经皮引流已被广泛接受为腹部脓肿的首选治疗方法。其适应证最近已得到明确,而没有安全的引流途径是唯一的绝对禁忌证。我们对65例不同部位腹部脓肿患者进行了该手术:肝脓肿27例,膈下脓肿33例,小网膜囊脓肿3例,肾周脓肿3例。总体成功率为85%,肝脓肿成功率为89%,膈下脓肿成功率为88%。尽管脓肿已得到妥善引流,但仍有6例患者死于多系统功能衰竭。4例患者因脓肿持续存在而接受了手术治疗。其中1例出现胰瘘,另1例的原发病变为腹膜包虫囊肿。5例患者发生气胸,其中2例需要进行胸腔引流。另外2例患者出现液气胸和脓胸,并进行了引流。总体并发症发生率为14%。因此,经皮引流是一种简单且成功率高的腹部脓肿治疗方法。结果受诊断准确性和患者选择是否恰当的影响。

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