Kelogrigoris M, Tsagouli P, Stathopoulos K, Tsagaridou I, Thanos L
Computed Tomography and Interventional Radiology Department, Sotiria Chest Diseases Hospital, Athens, Greece.
JBR-BTR. 2011 Jul-Aug;94(4):191-5. doi: 10.5334/jbr-btr.583.
To evaluate the safety and effectiveness of CT-guided percutaneous drainage of lung abscesses considering success rate versus complications.
This retrospective study was carried out at Computed Tomography and Interventional Radiology Department of Sotiria Hospital, Athens, Greece, from 1/1/2007 to 1/1/2010. Forty patients with lung abscesses in which antibiotic therapy failed and were managed with CT-guided percutaneous drainage were included in the study. Catheter placement was carried out using Trocar technique in the majority of the cases.
Lung abscess completely resolved with no residual cavity in thirty three patients. Seven patients had residual cavity and surgery was performed. Thus, the success rate of radiological drainage of the lung abscesses (33/40) was 83%. Five (13%) patients developed pneumothorax. Three developed moderate pneumothorax and chest-tube needed to be inserted and two patients developed mild pneumothorax which was managed with aspiration. These patients were kept under observation and followed-up by chest X-rays. No other complications and no mortality occurred during the procedure for all the forty patients.
CT-guided percutaneous catheter drainage is a useful and safe procedure for the treatment of patients with lung abscesses who do not respond to medical therapy and should be considered a valuable alternative to open surgery.
考虑成功率与并发症情况,评估CT引导下经皮肺脓肿引流术的安全性和有效性。
本回顾性研究于2007年1月1日至2010年1月1日在希腊雅典索蒂里亚医院的计算机断层扫描与介入放射科进行。纳入40例肺脓肿患者,这些患者抗生素治疗失败,采用CT引导下经皮引流术进行治疗。大多数病例采用套管针技术放置导管。
33例患者肺脓肿完全消退,无残留空洞。7例患者有残留空洞,接受了手术治疗。因此,肺脓肿放射引流的成功率(33/40)为83%。5例(13%)患者发生气胸。3例发生中度气胸,需要插入胸管,2例患者发生轻度气胸,通过抽吸进行处理。这些患者接受观察并通过胸部X线进行随访。40例患者在手术过程中均未发生其他并发症及死亡情况。
CT引导下经皮导管引流术对于药物治疗无效的肺脓肿患者是一种有用且安全的治疗方法,应被视为开放性手术的一种有价值的替代方法。