超声引导穿刺置管引流治疗细菌性肝脓肿患者疗效研究*

doi:10.3969/j.issn.1672-5069.2025.06.032

摘要/Abstract

摘要： 目的比较超声引导穿刺置管引流与穿刺引流治疗细菌性肝脓肿(PLA)患者的临床效果。方法 2023年1月～2025年6月我院收治的91例PLA患者,被分为两组,分别采取超声引导下穿刺置管引流治疗(n=45)或超声引导下穿刺引流治疗(n=46)。结果置管引流治疗组发热消退和脓腔闭合时间分别为(4.2±1.3)d和(10.7±2.8)d,均显著短于穿刺引流组【分别为(5.8±1.6)d和(14.3±3.1)d,P<0.05】,穿刺次数、抗生素应用时间和抗生素应用强度分别为(1.3±0.5)、(12.1±3.0)d和(30.2±2.8),均显著少于或低于穿刺引流组【分别为(3.1±1.0)、(15.6±3.4)d和(44.8±5.5),P<0.05】;在术后24 h和3 d,两组疼痛评分【分别为(3.8±1.0)对(3.6±1.2)和(2.1±0.8)对(2.2±1.0)】,和在术后7 d,两组活动能力评分【(69.2±7.5)对(67.5±8.3)】均无显著性差异(P>0.05),而置管引流治疗组住院日为(13.5±3.8)d,显著短于穿刺引流治疗组【(15.7±4.6)d,P<0.05】,脓腔复发率为2.2%,显著低于穿刺引流组的13.0%(P<0.05)。结论在超声引导下穿刺置管引流作为一种安全、有效的微创治疗方法,治疗PLA患者有效、安全,可加速脓腔闭合,缩短抗生素应用和住院时间,值得临床开展应用。

关键词: 细菌性肝脓肿, 超声引导, 穿刺置管引流, 治疗

Abstract: Objective The purpose of this study was to investigate efficacy of ultrasound (US)-guided catheter drainage in the treatment of patients with pyogenic liver abscess (PLA). Methods 91 patients with PLA were encountered in our hospital between January 2023 and June 2025, and were randomly assigned to underwent catheter drainage (CD) under US guidance in 45 cases or underwent puncture and aspiration (PAA) under US guidance in another 46 cases. Results Fever subsidence and abscess cavity closure times in CD-treated patients were(4.2±1.3)d and (10.7±2.8)d, both significantly shorter than [(5.8±1.6)d and (14.3±3.1)d, respectively, P<0.05], and puncture times, administration of antibiotics and defined daily doses (DDD) of antibiotics were (1.3±0.5)times, (12.1±3.0)d and (30.2±2.8), all significantly shorter or lower than [(3.1±1.0)times, (15.6±3.4)d and (44.8±5.5), respectively, P<0.05] in PAA-treated patients; by 24 hours and 3 days after operation, there were no significant differences as respect to visual analog scale (VAS) scores [(3.8±1.0)vs. (3.6±1.2) and (2.1±0.8)vs.(2.2±1.0)], or to physical performance measure / score by day 7 [(69.2±7.5) vs. (67.5±8.3), P>0.05] between the two groups, while hospital stay in CD-treated patients was (13.5±3.8)d, much shorter than [(15.7±4.6)d, P<0.05], and recurrence of abscess was 2.2%, much lower than 13.0% (P<0.05) in PAA-treated patients. Conclusion Ultrasound-guided puncture and catheter drainage is a safe and effective minimally invasive treatment for patients with PLA, which could significantly improve clinical symptoms subside, accelerate abscess cavity closure, with shorten antibiotic therapy and hospitalization.

Key words: Pyogenic liver abscess, Ultrasound guidance, Puncture and catheter drainage, Therapy

杭小露, 尹明. 超声引导穿刺置管引流治疗细菌性肝脓肿患者疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 926-929.

Hang Xiaolu, Yin Ming. Ultrasound-guided catheter drainage in treatment of patients with pyogenic liver abscess[J]. Journal of Practical Hepatology, 2025, 28(6): 926-929.

参考文献

[1] Huang Q, Huang ZX, Lin HX, et al. The relationshipbetween the triglyceride to high-density lipoprotein cholesterol ratio and positive blood or pus cultures in patients with pyogenic liver abscess. Lipids Health Dis, 2025, 24(1):267.
[2] Qiu F, Yang TC, Han W. Clinical application of ultrasound-guided surgical puncture and drainage in early treatment of pyogenic liver abscess. World J Gastrointest Surg, 2025, 17(7):107544.
[3] Zhang T, Cao X, Zhang L, et al. An individualized nomogram for predicting risk of sepsis in patients with pyogenic liver abscesses: a 10 years retrospective analysis. Front Med (Lausanne), 2025, 12:1555656.
[4] Nagendra D, R N, Shanbhag V, et al. Incidental detection of hypervirulent klebsiella pneumoniae liver abscess with systemic and cardiac complications in an elderly diabetic woman. Radiol Case Rep, 2025, 20(9):4674-4678.
[5] Sun L, Li X, Hou H, et al. Comprehensive transcriptome profiling in sepsis induced by pyogenic liver abscess. Biochim Biophys Acta Mol Basis Dis, 2025, 1871(7):167905.
[6] Ming Y, Wei H, Zhang Y, et al. The effect of contrast-enhanced ultrasound via vessels and surgical drains guidance percutaneous catheter drainage in the treatment of pyogenic liver abscess. Curr Med Imaging, 2024, 20:e15734056261616.
[7] Nie S, Lin D, Li X. Clinical characteristics and management of 106 patients with pyogenic liver abscess in a traditional Chinese hospital. Front Surg, 2023, 9:1041746.
[8] Zhang S, Xu Q, Liu C, et al. Management and prognostic prediction of pyogenic liver abscess in a Chinese tertiary hospital: Percutaneous needle aspiration vs catheter drainage. PLoS One, 2024, 19(12):e0315371.
[9] 李宏建, 许织文, 夏斐, 等. 超声引导穿刺引流治疗细菌性肝脓肿患者疗效研究. 实用肝脏病杂志, 2025, 28(3):454-457.
[10] 严广斌. 疼痛数字评价量表. 中华关节外科杂志( 电子版), 2014, 8(3): 410.
[11] 闵瑜, 吴媛媛, 燕铁斌. 改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究.中华物理医学与康复杂志, 2008, 12(3):185-188.
[12] Chung GC, Kim DS, Lee JE, et al. Endogenous endophthalmitis due to Klebsiella pneumoniae liver abscess: a retrospective study of clinical course, treatment pattern, and prognosis. Int J Ophthalmol, 2025, 18(8):1553-1560.
[13] Ding X, Yu Y, Chen M, et al. The microbiological features and risk factors for liver abscess after thermal ablation of liver cancer. Front Cell Infect Microbiol, 2025, 15:1567105.
[14] Majeed I, Swank R, Chadalapaka N, et al. Community-acquired resistant strain ofKlebsiella pneumoniae in an elderly hispanic patient in the United States: Causing Klebsiella-invasive syndrome with a primary liver abscess and antibiotic resistance. Cureus, 2025, 17(5):e83715.
[15] Zhang HF, Chen JW, Li SS, et al. Clinical characteristics and risk factors for blood culture-positive Klebsiella pneumoniae liver abscess: A retrospective study. Int Med Case Rep J, 2025, 18:609-619.
[16] Kuraria V, Paruthy SB, Singh AK, et al. Evaluation of APACHE II score as predictor of outcome in patients with ruptured liver abscess: prospective study in a tertiary care hospital. Sci Rep, 2025, 15(1):27291.
[17] Kinikar M, R Nangare N, V Nerlekar H. Pigtail catheter versus open surgical drainage in liver abscess management. Bioinformation, 2025, 21(3):414-417.
[18] Long HY, Yan X, Meng JX, et al. Predictivefactors for liver abscess liquefaction degree based on clinical, laboratory, and computed tomography data. World J Gastrointest Surg, 2025, 17(4):104615.
[19] Gupta SV, Akami K, Garg S, et al. The Gupta-Akami technique for percutaneous drainage of superficialliver abscess: An indigeneous economic method for low resources setups. Turk J Surg, 2024, 40(4):275-282.
[20] Jana A, Ray AK, Sarkar S, et al. A prospective study on the spectrum of liver abscess with special reference to ruptured abscess in a tertiary care hospital. Cureus, 2024, 16(10):e70743.

超声引导穿刺置管引流治疗细菌性肝脓肿患者疗效研究^*

Ultrasound-guided catheter drainage in treatment of patients with pyogenic liver abscess

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