Department of Emergency Medicine, The First People's Hospital of Lianyungang (The First Affiliated Hospital of Kangda College of Nanjing Medical University), Lianyungang City, Jiangsu Province 222061, China.
Department of Hepatobiliary Surgery, Huai'an Second People's Hospital (The Affiliated Huai'an Hospital of Xuzhou Medical University), Huai'an, Jiangsu 223000, China.
Comput Math Methods Med. 2022 Jul 6;2022:4688356. doi: 10.1155/2022/4688356. eCollection 2022.
Currently, the therapeutic effect and outcomes of US-PCD in patients with liver abscess and septic shock remain unclear. This study is aimed at investigating the effects of ultrasound-guided percutaneous catheter drainage (US-PCD) on the prognosis of patients with liver abscess complicated with septic shock.
We retrieved and assessed the data of 120 patients with liver abscess complicated with septic shock diagnosed at our hospital from January 2019 to March 2021. The patients underwent US-PCD in the observation group or conventional surgical incision and drainage in the control group. After treatment, we determined the levels of liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), and alkaline phosphatase (ALP) as well as the levels of inflammatory cytokines IL-6, IL-8, and TNF- in serum using ELISA on postoperative days 0, 2, 4, and 6. The postoperative body temperature recovery, peripheral white blood cell count recovery, extubation, postoperative length of stay, and complications were recorded, with a 12-month follow-up to calculate their survival rate.
After treatment, the ALT, AST, TBIL, DBIL, and ALP levels and inflammatory factor levels in the two groups were gradually reduced over time and returned to the normal range with a better recovery trend in the observation group. US-PCD was associated with better postoperative body temperature recovery, peripheral white blood cell count recovery, shorter extubation time, hospital stay, lower postoperative rate, and a higher survival rate.
US-PCD may be effective in treating liver abscess and can significantly improve the prognosis of patients.
目前,经皮穿刺置管引流(US-PCD)治疗肝脓肿合并感染性休克的疗效和结局尚不清楚。本研究旨在探讨超声引导下经皮穿刺置管引流(US-PCD)对肝脓肿合并感染性休克患者预后的影响。
检索并评估了 2019 年 1 月至 2021 年 3 月我院收治的 120 例肝脓肿合并感染性休克患者的数据。观察组患者行 US-PCD,对照组患者行常规手术切开引流。治疗后,采用酶联免疫吸附试验(ELISA)检测术后第 0、2、4、6 天血清中肝功能指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)和碱性磷酸酶(ALP)及炎症因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平。记录术后体温恢复、外周白细胞计数恢复、拔管时间、术后住院时间及并发症,随访 12 个月计算生存率。
治疗后,两组 ALT、AST、TBIL、DBIL、ALP 水平及炎症因子水平随时间逐渐降低,观察组恢复趋势较好,均恢复至正常范围。US-PCD 可更好地促进术后体温恢复、外周白细胞计数恢复、缩短拔管时间、住院时间,降低术后并发症发生率,提高生存率。
US-PCD 治疗肝脓肿可能有效,可显著改善患者预后。