摘要目的 对比分析穿刺引流与手术2种不同方式治疗细菌性肝脓肿的临床疗效.方法 回顾性分析81例细菌性肝脓肿临床资料.按治疗方式分为穿刺引流组(48例)和手术组(33例),比较2组患者的基本情况、实验室检查、有效率、并发症发生率、死亡率、术后体温恢复正常时间及住院时间.结果 81例患者中肺炎克雷伯杆菌在血培养阳性中占45.45％,在脓液培养阳性中占62.50％.有效率和死亡率比较差异无统计学意义(x2=0.91,2.05,P＞0.05).穿刺引流组患者住院时间(14±5)d显著低于手术组(17±5)d,2组相比差异有统计学意义(t=-3.20,P＜0.05).穿刺引流组患者术后体温恢复正常时间(5.1±1.6)d短于手术组(6.0±1.1)d,2组相比差异有统计学意义(t=-2.85,P＜0.05).穿刺引流组6例患者术后出现并发症,少于手术组的10例(x2=3.91,P ＜0.05).结论 超声引导下经皮肝穿刺引流治疗细菌性肝脓肿具有操作简单、疗效确切、并发症发生率低、术后恢复快等优点.

abstractsObjective To compare the clinical effectiveness between puncture drainage and surgery in the treatment of pyogenic liver abscess.Methods Clinical date of 81 patients with pyogenic liver abscess were retrospectively analyzed.Patients were divided into the ultrasound-guided puncture drainage group (48 patients) and open surgical drainage group (33 patients).The demographic data,laboratory examination,efficient rate,complication rate,mortality,time for body temperature returned to normal and hospital stays were compared between the two groups.Results Klebsiella pneumoniae was positive in 45.45％ cases by blood culture,and in 62.50％ cases by pus culture.There was no statistically significant difference in the effective rate and mortality (x2 =0.91,2.05,P ＞ 0.05).For patients with puncture drainage hospital stay was (14 ± 5) days,significantly shorter than (17 ± 5) days in surgery group (t =-3.20,P ＜ 0.05).Time to normal temperature was (5.1 ± 1.6) days in puncture drainage group,which was shorter than (6.0 ± 1.1) days in open surgery group (t =-2.85,P ＜ 0.05).Postoperative complications were fewer in the puncture drainage group (6 cases) than open surgery group (10 cases) (x2=3.91,P ＜ 0.05).Conclusions Ultrasound-guided puncture drainage for liver abscess is safe,feasible,effective of low complication rate for the treatment of pyogenic liver abscess.