摘要
目的:比较Trocar与Seldinger技术在超声引导下经皮肝脓肿穿刺置管引流中的应用。方法:回顾性分析2015年9月至2018年7月汕头市中心医院收治的肝脓肿患者,分为2组,其中A组27例选用Trocar技术,B组30例选用Seldinger技术。比较分析2组的置管总时间、并发症发生率、疗效等指标的差异。结果:(1)2组患者性别、年龄、术前白细胞、中性粒细胞、血浆凝血酶原时间差异均无统计学意义(P> 0.05);肝脓肿位置、脓肿最大直径差异有统计学意义(P <0.05)。(2)2组患者体温恢复正常时间及术后白细胞恢复正常时间比较,差异无统计学意义(P> 0.05);置管总时间比较,A组置管总时间较B组短,差异有统计学意义(P <0.05)。(3)并发症发生率比较,B组高于A组(23.3%> 7.4%),但差异无统计学意义(P> 0.05);2组治愈率差异无统计学意义(P> 0.05)。讨论:2种技术在超声引导下经皮肝脓肿穿刺置管引流中均具有较高的治愈率及较低的并发症发生率。在脓肿发生部位比较表浅、脓肿直径较大时应用Trocar技术能节省时间,具有并发症较少的优势;但当脓肿发生在深部、脓肿直径较小时应用Trocar技术较难操作成功,我们推荐应用Seldinger技术。
Objective:To compare the application of Trocar and Seldinger techniques in percutaneous drainage of liver abscess under ultrasound guidance.Methods:Patients with liver abscess in Shantou Central Hospital from September 2015 to July 2018 were divided into Group A and Group B for a retrospective analysis.Among them,27 cases in Group A underwent percutaneous drainage using the Trocar technique,whereas 30 cases in Group B underwent percutaneous drainage using the Seldinger technique.Differences in the total time of catheterization,the incidence of complications and the efficacy were compared between the two groups.Results:(1)There were no significant differences in gender,age,preoperative leukocyte count,neutrophil count and prothrombin time between the two groups(P>0.05).However,there were significant differences in the location of liver abscess and maximum diameter(P<0.05).(2)There were no significant differences between the two groups in the period for body temperature recovery and the recovery time of white blood cell count after operation(P>0.05).There was significant difference in the total time of catheterization between the two groups(P<0.05).The total time of tube placement in Group A is shorter than that in Group B.(3)The incidence of complications was higher in Group B than in Group A(23.3%>7.4%),but the difference has no statistically significance(P>0.05);the difference of the cure rate in both groups has no statistically significance(P>0.05).Conclusion:It is arguably that both methods have a high cure rate and low incidence of complications in ultrasound-guided percutaneous transhepatic drainage.Trocar technique is time saving when the abscess is relatively superficial and when the abscess size is large.It boasts the advantage of fewer complications.However,when it comes to an internal abscess or a small abscess,it is difficult to apply the Trocar technique;instead,Seldinger technique is recommended.
作者
卢来顺
马锐
吴映云
王良玉
LU Laishun;MARui;WU Yingyun;WANG Liangyu(Department of Ultrasound Diagnosis,Shantou Central Hospital,Shantou 515031,China)
出处
《汕头大学医学院学报》
2019年第1期10-13,共4页
Journal of Shantou University Medical College
