CT引导下置管引流术治疗肺脓肿的临床应用价值.docVIP

CT引导下置管引流术治疗肺脓肿的临床价值 汪平1、孟凡堰2、肖昆3、陈亮1、郑崇乐1 （贵州省安顺市人民医院：1、胸外科；2、药剂科；3、影像科，贵州安顺，561000） 作者简介：汪平，男，学士学位，副主任医师。研究方向：胸外科。 摘要：目的 评价CT引导下置管引流术治疗肺脓肿的临床价值。方法 经内科保守治疗2～3周无明显好转的38例肺脓肿患者采用CT引导下肋间置管引流术，并结合抗感染治疗,随访观察治疗效果与并发症情况。结果 38例均一次置管成功。其中，30例体温4~24h降至正常，8例72h内降至正常。1例出现轻微支气管胸膜瘘。所有患者均无医源性气胸发生，脓腔减少均大于70%。平均住院时间为16.8天。随访2~12个月，均无复发。结论 经单纯内科治疗2～3周以上病变未见明显吸收，脓肿直径4cm以上，并与胸膜有实质性粘连的肺脓肿患者，易开展CT引导下置管引流术，该操作简单、微创、安全、疗效确切，有效缩短疗程，提高治愈率，降低治疗费用，值得临床推广应用。 关键词：肺脓肿；引流术；电子计算机横断扫描 Clinical Value of percutaneous catheter drainage for lung abscess under CT guidance Wang Ping1, Meng Fanyan 2, Xiao Kun3, Chen Liang1, Zheng Chongle1 （1.Thoracic Surgery; 2.Dept. of Pharmacy; 3. Dept. of Radiology. Anshun Municipal People’s Hospital, Anshun 561000, China） Abstract: Objective To Evaluate the clinical value of percutaneous catheter drainage for lung abscess under CT guidance. Methods No significant improvement after conservative treatment for 2 to 3 weeks, 38 patients of lung abscess underwent percutaneous catheter drainage under CT guidance, and combined with the anti-infective therapy. The clinical effect and complication were observed after the operation. Results The catheterizations for all of cases were successful at one time. The temperature of 30 patients reduced to normal between 4 to 24 hours, and 8 patients within 72 hours. One case had a slight bronchopleural fistula. All patients had no iatrogenic pneumothorax and all the abscess cavity reduced more than 70%. Average of hospital stay is 16.8 days. All patients had no recurrence in the follow-up period of 2 to 12 months. Conclussin CT guided catheter drainage is eligible for those patients of lung abscess with no significant improvement after conservative treatment for 2 to 3 weeks, diameter of abscess more than 4 cm, and substantive adhesions with pleural. The operation is simple, minimally invasive, safe, efficient, and worthy of clinical application for effectively shortening the course of treatment, improving the cure rate and reduci