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肝脓肿的治疗:导管引流与针吸术的前瞻性随机对照比较

Treatment of liver abscess: prospective randomized comparison of catheter drainage and needle aspiration.

作者信息

Singh Sukhjeet, Chaudhary Poras, Saxena Neeraj, Khandelwal Sachin, Poddar Deva Datta, Biswal Upendra C

机构信息

Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital (Dr RMLH and PGIMER), New Delhi, India.

出版信息

Ann Gastroenterol. 2013;26(4):332-339.

Abstract

BACKGROUND

The aim of the study was to evaluate the clinical presentation, and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses.

METHODS

This is a prospective randomized comparative study of 60 patients, presented in outpatient and emergency department at the hospital, randomized equally into two groups, percutaneous needle aspiration and pigtail catheter drainage. The effectiveness of either treatment was measured in terms of duration of hospital stay, days to achieve clinical improvement, 50% reduction in abscess cavity size and total/near total resolution of abscess cavity. Independent t-test was used to analyze these parameters.

RESULTS

The success rate was significantly better in catheter drainage group (P=0.006). The patients in pigtail catheter drainage group showed earlier clinical improvement (P=0.039) and 50% decrease in abscess cavity volume (P=0.000) as compared to those who underwent percutaneous needle aspiration.

CONCLUSION

Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus.

摘要

背景

本研究旨在评估肝脓肿的临床表现,并比较持续导管引流与穿刺抽吸引流在治疗肝脓肿方面的有效性。

方法

这是一项针对60例患者的前瞻性随机对照研究,这些患者来自医院门诊和急诊科,被随机分为两组,即经皮穿刺抽吸组和猪尾导管引流组。通过住院时间、临床症状改善天数、脓肿腔大小缩小50%以及脓肿腔完全/接近完全消退来衡量两种治疗方法的有效性。采用独立t检验分析这些参数。

结果

导管引流组的成功率显著更高(P=0.006)。与经皮穿刺抽吸组相比,猪尾导管引流组患者临床症状改善更早(P=0.039),脓肿腔体积缩小50%(P=0.000)。

结论

与经皮穿刺抽吸相比,经皮导管引流是一种更好的治疗方式,尤其适用于较大的、部分液化或脓液较稠的脓肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/246a/3959473/ac3ed92acc8d/AnnGastroenterol-26-332-g002.jpg

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