丁标CT引导下经皮穿刺治疗深部腹腔脓肿44体技术分析.doc

CT引导下经皮穿刺引流治疗深部腹腔脓肿44例体会 丁 标1 刘希胜2(通讯作者) 1 江苏省射阳县人民医院CT室，江苏 盐城 224300；南京医科大学第一附属医院放射科，江苏 南京 2100 29 摘要 目的：探讨CT引导下经皮穿刺引流治疗深部腹腔脓肿的临床应用价值。方法：随访并回顾分析44例接受猪尾巴导管植入引流治疗的深部腹腔脓肿病例。结果：44例腹腔脓肿均获成功穿刺。共引流脓腔52个，其中采用细针穿刺经导丝引入猪尾巴导管法（seldinger法）11个；采用猪尾巴套管直接穿刺法41例。2例因其他原因死亡，2例多房脓肿引流后外科手术治疗，其余40例治愈，治愈率达90.91%。并发症5例，发生率11.36%，其中出血1例，术后疼痛2例，导管滑脱2例。结论：CT引导下经皮穿刺治疗深部腹腔脓肿，是值得推广的介入微创技术。 关键词：深部腹腔脓肿 经皮穿刺脓肿引流 CT导向引流 CT guided precut-aneous puncture drainage treatment of 44 cases of deep abdominal abscess DING Biao1 , LIU Xisheng2 * (1.Department of CT, Sheyang County Peoples Hospital?,Yancheng 224300, China , 2.Department of Radiology Jiangsu Province Peoples Hospital,Nanjing,210029，China *Corresponding author) Abstract：Objective: To investigate the clinical value of the CT-guided percutaneous drainage (PAD) to treat the deep intra-abdominal abscess. Methods: 44 patients with deep abdominal abscesses were followed up who had underwent PAD treatment between January 2014 and June 2014, and retrospective analysis the effectiveness and safety of PAD. Results: All procedures were performed successfully under local anesthesia and CT guidance . Pigtail drainage catheters were placed in 52 abscess cavities of 44 cases using the direct puncture method or Seldinger technique. Success was defined as complete resolution of the intra-abdominal abscess in 40 cases. 2 patients died because of other complications, 2 patients with multilocular abscess received open surgical drainage after PAD. The success rate of PAD was 90.91% (n=44). PAD-related complications were seen in 5 patients (11.36%), with bleeding in 1 case, postoperative pain in 2 cases, catheter slippage in 2 cases. Conclusion: CT guided PAD to treat the deep abdominal abscess is encouraged as an effective, safe and minimally invasive interventional radiological technique. Keywords: Deep intra-abdominal abscess, Percutaneous abscess drainage, CT-guided drainage 腹腔脓肿是腹腔间隙细菌感染后，局部组织坏死液化形成的脓腔。随着介入技术的发展，CT引导下经皮穿刺引流已越来越多地用于临床，使许多腹腔脓肿患者，通过微创的介