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肢体积液的经皮引流

Percutaneous drainage of fluid collections in the extremities.

作者信息

Wu H P, Vesely T M

机构信息

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.

出版信息

Radiology. 1998 Jul;208(1):159-65. doi: 10.1148/radiology.208.1.9646808.

Abstract

PURPOSE

To analyze the results of percutaneous drainage of fluid collections in the extremities.

MATERIALS AND METHODS

From 1990-1997, 28 patients aged 14-90 years underwent percutaneous drainage of 33 fluid collections in the extremities; two patients underwent multiple drainages. Fluid collections were in the hip-groin area (n = 16), thighs (n = 6), buttocks (n = 6), knees (n = 3), calf (n = 1), and axilla (n = 1). Three intraarticular collections were included. The patients who had undergone prior procedures were eight who had undergone surgical drainage, 10 who had undergone needle aspiration, and one who had undergone surgical débridement. The two most common guidance methods of catheter placement were ultrasound localization and fluoroscopy.

RESULTS

The average drainage duration was 18.2 days (range, 1-93 days). The estimated cavity sizes were 4-733 cm3. Purulent fluid was drained in 13 patients. Staphylococcus aureus was the most commonly identified organism (n = 9). Nine patients had postoperative lymphoceles; five of these patients underwent sclerotherapy. Two (7%) patients had two complications, one of which was major. Failure occurred in four (16%) of 25 patients; two needed repeat drainage for recurrence, and two needed subsequent surgery. Success could not be determined in three patients who were lost to follow-up.

CONCLUSION

Percutaneous drainage of fluid collections in the extremities is an effective alternative to open-incision drainage in inpatients and outpatients.

摘要

目的

分析肢体积液经皮引流的结果。

材料与方法

1990年至1997年,28例年龄在14至90岁的患者接受了肢体33处积液的经皮引流;2例患者接受了多次引流。积液位于髋腹股沟区(n = 16)、大腿(n = 6)、臀部(n = 6)、膝盖(n = 3)、小腿(n = 1)和腋窝(n = 1)。其中包括3例关节内积液。曾接受过先前治疗的患者中,8例接受过手术引流,10例接受过针吸,1例接受过手术清创。导管置入最常用的两种引导方法是超声定位和荧光透视。

结果

平均引流持续时间为18.2天(范围1至93天)。估计腔隙大小为4至733 cm³。13例患者引出脓性液体。金黄色葡萄球菌是最常见的病原体(n = 9)。9例患者术后出现淋巴囊肿;其中5例患者接受了硬化治疗。2例(7%)患者出现两种并发症,其中一种为严重并发症。25例患者中有4例(16%)引流失败;2例因复发需要再次引流,2例需要后续手术。3例失访患者的引流效果无法确定。

结论

肢体积液的经皮引流是住院和门诊患者切开引流的有效替代方法。

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