Stylianos S, Martin E C, Starker P M, Laffey K J, Bixon R, Forde K A
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York.
J Trauma. 1989 May;29(5):584-8. doi: 10.1097/00005373-198905000-00007.
Between January 1, 1984, and June 30, 1987, we performed percutaneous catheter drainage (PCD) of 28 intra-abdominal abscesses in 21 postoperative trauma patients. During this period only three patients had abdominal re-exploration for drainage of abdominal abscess. The PCD patients were predominantly young men who had sustained penetrating abdominal injuries (81% GSW or SW; 19% MVA). Seventeen (81%) patients had multiple abdominal organ injuries with the colon being the most frequently injured (57%). Multiple abscesses were identified in 33% of the patients. All 21 patients had successful treatment of their abscesses by PCD alone. There was one complication (4.8%) from PCD (pneumothorax) and no deaths in this group. Our data suggest that in most cases, PCD can be safe, effective, and definitive treatment for postoperative intra-abdominal abscesses following abdominal trauma. We recommend PCD in all postoperative trauma patients who develop accessible abdominal abscesses before resorting to re-exploration.
1984年1月1日至1987年6月30日期间，我们对21例术后创伤患者的28个腹腔内脓肿进行了经皮导管引流（PCD）。在此期间，只有3例患者因腹腔脓肿引流而进行了腹部再次探查。接受PCD治疗的患者主要是遭受穿透性腹部损伤的年轻男性（81%为枪伤或刺伤；19%为机动车事故伤）。17例（81%）患者有多处腹部器官损伤，其中结肠损伤最为常见（57%）。33%的患者发现有多个脓肿。所有21例患者仅通过PCD就成功治愈了脓肿。PCD有1例并发症（4.8%）（气胸），该组无死亡病例。我们的数据表明，在大多数情况下，PCD对于腹部创伤术后腹腔内脓肿是一种安全、有效且决定性的治疗方法。我们建议，对于所有术后创伤患者，若出现可经皮处理的腹腔脓肿，应先采用PCD治疗，而非直接进行再次探查。
