Hashimoto L, Hermann R, Grundfest-Broniatowski S
Department of General Surgery, Cleveland Clinic Foundation, OH 44195, USA.
Am Surg. 1995 May;61(5):407-11.
From 1980 to 1991, 56 cases of pyogenic liver abscess were treated at the Cleveland Clinic. The most frequently used treatment was percutaneous catheter drainage of the abscess under computed tomography (CT) guidance (39 patients), followed by CT-guided aspiration without catheter drainage (10 patients). Six patients were initially treated by open operative drainage; another five were operated upon after CT guided drainage had failed. One patient with advanced pancreatic cancer was treated with antibiotics only. The overall mortality rate was 12.5% (7/56). It is clear that the preferred method of treatment for pyogenic hepatic abscess is now CT guided catheter drainage. Operative drainage is reserved for patients who fail to respond to percutaneous drainage or in whom surgery is indicated for other purposes. Aspiration without catheter drainage is a modality that needs further evaluation to define its indications.
1980年至1991年期间，克利夫兰诊所共治疗了56例化脓性肝脓肿患者。最常用的治疗方法是在计算机断层扫描（CT）引导下经皮导管引流脓肿（39例患者），其次是CT引导下穿刺抽吸但不进行导管引流（10例患者）。6例患者最初接受了开放手术引流；另外5例在CT引导引流失败后接受了手术。1例晚期胰腺癌患者仅接受了抗生素治疗。总死亡率为12.5%（7/56）。显然，目前化脓性肝脓肿的首选治疗方法是CT引导下导管引流。手术引流适用于对经皮引流无反应的患者或因其他原因需要手术的患者。无导管引流的穿刺抽吸作为一种治疗方式，需要进一步评估以明确其适应证。
