腹部手术后脓肿经皮引流失败的预测因素。
Predictive factors for failure of percutaneous drainage of postoperative abscess after abdominal surgery.
机构信息
Surgical Oncologic & Digestive Unit, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
Department of Body & Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Diderot-Paris 7, 75475 Paris Cedex 10, France; INSERM U965, Paris, France.
出版信息
Am J Surg. 2014 Jun;207(6):915-21. doi: 10.1016/j.amjsurg.2013.07.041. Epub 2013 Nov 7.
BACKGROUND
The aims of this study were to assess the efficacy of percutaneous drainage of postoperative abscess after abdominal surgery and to identify factors predictive of failed drainage.
METHODS
Data from 81 patients with postoperative abdominopelvic abscesses treated with percutaneous drainage were reviewed. Percutaneous drainage failure was considered when surgery was needed to control the sepsis. Predictive variables were sought using univariate and multivariate analyses with logistic regression models.
RESULTS
Successful drainage requiring 1 (n = 46) or 2 (n = 17) procedures was observed in 63 patients (78%; 95% confidence interval, 67%-86%). Surgery was needed in 18 patients (22%; 95% confidence interval, 14%-38%). Residual collection after a first percutaneous drainage was the single predictive factor for failed drainage on univariate and multivariate analyses (P = .0275).
CONCLUSIONS
Percutaneous imaging-guided drainage is a feasible and effective method for the treatment of abdominopelvic abscess, with a success rate of 78%. Residual collection is an independent predictor of unfavorable outcome after percutaneous drainage.
背景
本研究旨在评估腹部手术后脓肿经皮引流的疗效，并确定预测引流失败的因素。
方法
回顾了 81 例经皮引流治疗的腹盆腔术后脓肿患者的数据。当需要手术控制脓毒症时，认为经皮引流失败。使用单因素和多因素分析以及逻辑回归模型寻找预测变量。
结果
63 例患者（78%；95%置信区间，67%-86%）经 1 次（n=46）或 2 次（n=17）引流操作成功引流。18 例患者（22%；95%置信区间，14%-38%）需要手术。单因素和多因素分析均显示，首次经皮引流后仍有积液是引流失败的唯一预测因素（P=0.0275）。
结论
经皮影像引导引流是治疗腹盆腔脓肿的一种可行且有效的方法，成功率为 78%。引流后仍有积液是经皮引流不良结局的独立预测因素。
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