Hoffer F A, Emans J
Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Pediatr Radiol. 1996 Dec;26(12):879-81. doi: 10.1007/BF03178042.
Intravenous antibiotics and surgical drainage are the accepted methods of treating osteomyelitis complicated by abscess formation. The objective of this study was to determine whether percutaneous drainage of subperiosteal abscess is a potential treatment for osteomyelitis.
Three pediatric patients with subperiosteal abscesses from acute osteomyelitis had percutaneous drainage with sonographic and fluoroscopic guidance using a Seldinger technique and an 8-F catheter.
Two patients required no further intervention and had the drainage catheter removed after 72 h. After completing a course of antibiotics they healed completely. One patient, after a week of purulent drainage, required open drainage including a bone debridement of an area of septic necrosis.
Percutaneous drainage of subperiosteal abscess may be an alternative to surgical drainage when medical therapy alone is inadequate. Development of intraosseous abscess, necrosis or persistent drainage suggests further intervention may be necessary.
静脉使用抗生素和手术引流是治疗并发脓肿形成的骨髓炎的公认方法。本研究的目的是确定经皮引流骨膜下脓肿是否是骨髓炎的一种潜在治疗方法。
3例急性骨髓炎合并骨膜下脓肿的儿科患者在超声和透视引导下采用Seldinger技术和8F导管进行经皮引流。
2例患者无需进一步干预，72小时后拔除引流导管。完成抗生素疗程后，他们完全康复。1例患者在脓性引流一周后，需要进行包括对感染坏死区域进行骨清创术的开放引流。
当单独的药物治疗不足时，经皮引流骨膜下脓肿可能是手术引流的一种替代方法。骨内脓肿、坏死或持续引流的出现表明可能需要进一步干预。
