Deveney C W, Lurie K, Deveney K E
Department of Surgery, Oregon Health Sciences University, Portland.
Arch Surg. 1988 Sep;123(9):1126-30. doi: 10.1001/archsurg.1988.01400330106016.
Outcome in patients with abdominal abscesses treated at the University of Pennsylvania, Philadelphia, between 1973 and 1978 (group 1) was compared with that in patients treated between 1981 and 1986 (group 2). Mortality was less in group 2 patients (21% vs 39% in group 1). The decrease in mortality in group 2 was accompanied by a greater percentage of successful predrainage localization (74% vs 55% in group 1), successful initial drainage (76% vs 55% in group 1), and decreased predrainage organ failure (23% vs 52% in group 1). Because failure of initial drainage and predrainage organ failure were associated with increased mortality, improvement in both of these criteria contributed substantially to the lower mortality in group 2 patients. There were no differences in mortality, in initial success in drainage, or in length of hospital stay when 29 group 2 patients who underwent percutaneous drainage were compared with 37 patients who underwent surgical drainage. Mortality (22% vs 21%) and initial success (78% vs 72%) were similar for patients who underwent surgical and percutaneous drainage, respectively. We conclude that initial success in localization and drainage of the abscess is more important than whether drainage is surgical or percutaneous.
将1973年至1978年在费城宾夕法尼亚大学接受治疗的腹部脓肿患者（第1组）的治疗结果与1981年至1986年接受治疗的患者（第2组）的结果进行了比较。第2组患者的死亡率较低（第2组为21%，第1组为39%）。第2组死亡率的降低伴随着更高比例的成功预引流定位（第2组为74%，第1组为55%）、成功初始引流（第2组为76%，第1组为55%）以及预引流器官衰竭的减少（第2组为23%，第1组为52%）。由于初始引流失败和预引流器官衰竭与死亡率增加相关，这两个标准的改善在很大程度上导致了第2组患者较低的死亡率。当将29例接受经皮引流的第2组患者与37例接受手术引流的患者进行比较时，在死亡率、初始引流成功率或住院时间方面没有差异。接受手术引流和经皮引流的患者的死亡率（分别为22%和21%）和初始成功率（分别为78%和72%）相似。我们得出结论，脓肿定位和引流的初始成功比引流是通过手术还是经皮进行更为重要。
