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经皮导管引流治疗腹部脓肿:五年经验

Percutaneous catheter drainage of abdominal abscesses: a five-year experience.

作者信息

Gerzof S G, Robbins A H, Johnson W C, Birkett D H, Nabseth D C

出版信息

N Engl J Med. 1981 Sep 17;305(12):653-7. doi: 10.1056/NEJM198109173051201.

Abstract

We used computed tomography (CT) and ultrasonography for detection and localization of intra-abdominal abscesses. On the basis of these images, safe routes for diagnostic aspiration and percutaneous drainage were planned. Over these routes indwelling catheters were inserted to provide immediate decompression, evacuation, and continuous drainage until the abscess resolved. All patients received concomitant intravenous antibiotics. The treatment was used for 71 abscesses in 67 patients. Sixty-one abscesses (86 per cent) were satisfactorily drained. There were 11 complications (15 per cent). Six deaths were attributable to sepsis, three of which (4 per cent) were related to inadequate drainage. There was one recurrence (1 per cent) during a follow-up period ranging from one month to five years (means, 22.3 months). The mean duration of treatment was 20.2 days (range, five to 120 days). We conclude that percutaneous drainage is an effective method for treatment of abdominal abscesses and is indicated when sectional imaging demonstrates an accessible unilocular lesion.

摘要

我们使用计算机断层扫描(CT)和超声检查来检测和定位腹腔内脓肿。根据这些图像,规划了诊断性穿刺和经皮引流的安全路径。通过这些路径插入留置导管,以实现即时减压、排空,并持续引流直至脓肿消退。所有患者均同时接受静脉抗生素治疗。该治疗方法用于67例患者的71个脓肿。61个脓肿(86%)得到了满意的引流。发生了11例并发症(15%)。6例死亡归因于败血症,其中3例(4%)与引流不充分有关。在1个月至5年(平均22.3个月)的随访期内有1例复发(1%)。平均治疗时间为20.2天(范围为5至120天)。我们得出结论,经皮引流是治疗腹腔脓肿的有效方法,当断层成像显示为可及的单房性病变时即应采用。

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