Drolsum A, Skjennald A
Røntgenavdelingen, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1994 Nov 20;114(28):3327-30.
Percutaneous drainage of abdominal abscesses has proved to be one of the most successful and gratifying of all interventional radiology procedures. Collections of intra-abdominal fluid can be detected easily with computer tomography and sonography. Diagnostic aspiration is done under guidance of sonography or computer tomography. Sonography is the ideal imaging method for monitoring interventional procedures. Its ability to visualize the collection of superficial fluid and its real-time capability allows precise control of insertions of needles and catheters. If the collection is poorly seen with sonography, often because of air, computer tomography can be used as a system of guidance. It is essential that radiologists and surgeons collaborate in the treatment of patients with abscesses. Percutaneous drainage is favoured in patients at high risk with open surgery, while diffuse collections between bowels almost always need surgical drainage. Simple abscesses can be treated successfully with percutaneous drainage. Complicated abscesses in the pancreas can also be treated with good results. The procedure is carried out under local anaesthesia. Most complications are minor and can be treated conservatively. Coagulation abnormalities must be corrected, but there are no other contraindications to these image-guided percutaneous procedures.
经皮穿刺引流腹腔脓肿已被证明是所有介入放射学操作中最成功、最令人满意的操作之一。腹腔内液体的积聚可以通过计算机断层扫描和超声检查轻松检测到。诊断性穿刺抽吸在超声或计算机断层扫描引导下进行。超声是监测介入操作的理想成像方法。它能够可视化浅表液体的积聚及其实时功能,允许精确控制针和导管的插入。如果超声检查对积液显示不佳,通常是因为有气体,则可以使用计算机断层扫描作为引导系统。放射科医生和外科医生在脓肿患者的治疗中合作至关重要。对于高风险的开放手术患者,经皮引流是首选,而肠间的弥漫性积液几乎总是需要手术引流。简单的脓肿可以通过经皮引流成功治疗。胰腺的复杂脓肿也可以得到良好的治疗效果。该操作在局部麻醉下进行。大多数并发症轻微,可以保守治疗。必须纠正凝血异常,但这些影像引导下的经皮操作没有其他禁忌症。