腹腔镜手术和介入治疗盆腔脓肿疗效分析.docVIP

腹腔镜手术和介入治疗盆腔脓肿疗效分析 　　【摘要】 目的：分析腹腔镜手术以及CT引导下经皮穿刺引流治疗盆腔脓肿的疗效，探讨盆腔脓肿的最佳治疗手段。方法：对69例盆腔脓肿患者的临床资料进行回顾分析，腹腔镜手术治疗的患者38例，行CT导引下经皮穿刺引流治疗的患者31例，比较这两种方法治疗盆腔脓肿的效果。结果：腹腔镜手术时间明显长于介入手术治疗时间，腹腔镜手术出血量明显多于介入手术出血量，比较差异均有统计学意义（P0.01），而治愈率及有效率比较差异均无统计学意义，但复发率比较差异有统计学意义（P0.05）。结论：CT引导下经皮穿刺引流是治疗盆腔脓肿的一个较为理想的方法。介入治疗盆腔脓肿创伤性明显小于腹腔镜手术、治疗效果等同于腹腔镜手术，并且复发率明显低于腹腔镜手术。 　　【关键词】 盆腔脓肿； 腹腔镜手术； 介入治疗 　　【Abstract】 Objective： To explore the best treatment of pelvic abscess， through the analysis of laparoscopic operation and CT guided percutaneous puncture drainage effect in the treatment of pelvic abscess. Method： Clinical data of 69 patients suffering from pelvic abscess were analyzed retrospectively. Among them， 38 patients were given laparoscopic surgery treatment. 31 cases were given percutaneous puncture drainage treatment， under the CT guidance. The treatment efficacy of the two groups was compared. Result： The operation time was significantly longer than the interventional operation treatment， and the volume of hemorrhage during operation between the two groups were significantly different （P0.01）. The cure rate and effective rate were not statistically significant. The recurrence rate had significant difference （P0.05）. Conclusion： Under the CT guidance， percutaneous puncture drainage is an ideal method for treatment of pelvic abscess. Interventional treatment of pelvic abscess is smaller than the laparoscopic operation trauma. Treatment is equivalent to laparoscopic operation. The recurrence rate is significantly lower than that in laparoscopic operation. 　　【Key words】 Pelvic abscess； Laparoscopic surgery； Treatment of intervention 　　First-author’s address： Dalian Maternal Child Health Hospital， Dalian 116033， China 　　doi：10.3969/j.issn.1674-4985.2015.01.017 　　盆腔脓肿是盆腔炎性疾病较为严重的一种临床表现[1]，病因多样复杂，可由多种病原体逆行感染而致病[2]。临床中不易与妇科其他疾病及外科疾病相鉴别，容易造成误诊，一旦脓肿破裂，可致泛发性腹膜炎、感染性休克、败血症，危及生命[3]。临床上经抗炎治疗48～72 h无效，应考虑手术治疗。本文旨在探讨盆腔脓肿治疗的最佳方法，以最小的创伤解决盆腔脓肿患者最大的痛苦。 　　1 资料与方法 　　1.1 一般资料 回顾分析2010年以前于本院行盆腔脓肿腹腔镜手术治疗的女性患者38例