超声引导穿刺引流治疗细菌性肝脓肿患者疗效研究*

doi:10.3969/j.issn.1672-5069.2025.03.034

摘要/Abstract

摘要： 目的观察在超声引导下穿刺引流治疗细菌性肝脓肿患者的疗效。方法 2020年10月～2023年10月我院收治的96例细菌性肝脓肿患者,被随机分为观察组48例和对照组48例,分别给予超声引导下穿刺置管引流或超声引导下穿刺抽吸治疗。采用ELISA法检测血清丙二醇(MDA)、超氧化物歧化酶(SOD)和皮质醇(COR)水平,采用ELISA法检测血清白细胞介素-6(IL-6)、IL-8和IL-12水平。结果经1～3周治疗,两组均治愈,脓腔闭合,随访3月,经超声检查未发现脓肿复发病例;治疗后观察组血清TBIL、ALT、ALB和GGT水平分别为(15.3±2.4)μmol /L、(72.4±7.5)U/L、(39.3±2.8)g/L和(79.3±19.4)U/L,与对照组【分别为(16.5±2.3)μmol /L、(73.2±10.3)U/L、(36.6±2.9)g/L和(73.1±22.3)U/L】比,差异无统计学意义(P>0.05);观察组血清SOD、COR和MDA水平分别为(73.3±7.5)U/mL、(117.8±8.4)nmol/L和(5.1±0.8)μmol/mL,与对照组【分别为(75.4±7.1)U/mL、(118.8±8.5)nmol/L和(5.5±0.9)μmol/mL】比,差异无统计学意义(P>0.05);观察组血清IL-6、IL-8和IL-12水平分别为(0.2±0.1)ng/mL、(0.3±0.1)ng/mL和(81.3±16.5)ng/mL,均显著低于对照组【分别为(0.3±0.1)ng/mL、0.4±0.1)ng/mL和(95.2±17.1)ng/mL,P＜0.05】。结论采取在超声引导下穿刺置管引流治疗肝脓肿患者效果肯定,可减少穿刺次数,缩短治疗时间,减少抗生素用量。

关键词: 细菌性肝脓肿, 超声引导, 穿刺置管引流, 细胞因子, 治疗

Abstract: Objective The aim of this study was to investigate intrapurulent catheter drainage under ultrasound guidance in the treatment of patients with bacterial liver abscess (BLA). Method A total of 96 patients with BLA were encountered in our hospital between October 2020 and October 2023, and were randomly divided into observation group (n=48) and control group (n=48), received intrapurulent catheter drainage or puncture drainage under ultrasound guidance. Supporting management was given in the two groups. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and cortisol (COR) levels were assayed by ELISA, and serum interleukin-6 (IL-6),IL-8 and IL-12 levels were also detected by ELISA. Result All patients with BLA recovered in our series after one to three week treatment, presenting with disappeared purulent cavity, and no relapse was found by end of three month follow-up; after treatment, serum bilirubin, ALT and GGT levels in the observation group were(15.3±2.4)μmol /L, (72.4±7.5)U/L, (39.3±2.8)g/L and (79.3±19.4)U/L, all not significantly different compared to [(16.5±2.3)μmol /L, (73.2±10.3)U/L, (36.6±2.9)g/L and (73.1±22.3)U/L, respectively] in the control (P>0.05); serum SOD, COR and MDA levels in the observation were (73.3±7.5)U/mL, (117.8±8.4)nmol/L and (5.1±0.8)μmol/mL, all not significantly different as compared to [(75.4±7.1)U/mL, (118.8±8.5)nmol/L and (5.5±0.9)μmol/mL, respectively] in the control group (P>0.05); serum IL-6, IL-8and IL-12 levels in the observation were (0.2±0.1)ng/mL, (0.3±0.1)ng/mL and (81.3±16.5)ng/mL, all much lower than [(0.3±0.1)ng/mL, 0.4±0.1)ng/mL and (95.2±17.1)ng/mL, respectively, P＜0.05] in the control group. Conclusion We recommend intrapurulent catheter drainage under ultrasound guidance in dealing with patients with BLA, which might need less puncture and less antibiotic administration, with relatively quick recovery.

Key words: Bacterial liver abscess, Ultrasound guidance, Intrapurulent catheter drainage, Cytokines, Therapy

李宏建, 许织文, 夏斐, 盛建国. 超声引导穿刺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(3): 454-457.

Li Hongjian, Xu Zhiwen, Xia Fei, et al. Intrapurulent catheter drainage under ultrasound guidance in the treatment of patients with bacterial liver abscess[J]. Journal of Practical Hepatology, 2025, 28(3): 454-457.

参考文献

[1] 王术,郑旭婷,田素飞,等.社区获得性化脓性肝脓肿的单中心回顾性临床流行病学研究.中华传染病杂志, 2020,38(5):288-293.
[2] Steele RW .Treatment of a large multiloculated liver abscess with intra-abscess antibiotic instillation. Pediatr Infect Dis J, 2021, 40(1):83-84.
[3] Carbajo AY,Brunie VFJ ,Javier GF ,et al.Retrospective cohort study comparing endoscopic ultrasound‐guided and percutaneous drainage of upper abdominal abscesses.Dig Endosc,2019,31(4):431-438.
[4] Stotz MK , Crossland WL .PSVII-40 late-breaking abstract: ultrasonography and bacterial community of naturally occurring liver abscesses and non-abscessed livers in finishing holstein steers.J Anim Sci, 2020,98(4):339-340.
[5] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018年). 临床急诊杂志,2018,19(9):567-588.
[6] Jin QL ,Yao L ,Chun HL,et al.Clinical features and etiological analysis for 157 cases of pyogenic liver abscess.Med Sci,2021,46(7):711-718.
[7] 伍月兰,黎家琦,姚宇航,等. 细菌性肝脓肿合并糖尿病患者的临床特征及预后分析. 中华传染病杂志,2023,41(5):331-337.
[8] Abdourahmane N ,Jacques NT ,Adja D ,et al.Efficacy oflaparoscopic surgery in the treatment of hepatic abscess: a systematic review and meta-analysis.Ann Med Surg ,2022,75(31):103308-103308.
[9] Bezruchko MV , Panasenko SI , Osipov OS ,et al.Experience of application of interventional sonography in treatment of patients with bacterial hepatic abscesses.Klin Khir, 2020, 87(4):31-34.
[10] Okamoto T, Nakamura K, Takasu A,et al.Needle tract seeding and abscess associated with pancreatic fistula after endoscopic ultrasound-guided fine-needle aspiration.Clin J Gastroenterol, 2020 ,13(6):1322-1330.
[11] Surya M, Bhoil R, Sharma YP.Study of ultrasound-guided needle aspiration and catheterdrainage in the management of liver abscesses.J Ultrasound, 2020,23(4):553-562.
[12] Qin L ,Xiao YZ ,Chang C,et al.Clinical features and risk factors for pyogenic liver abscess caused by multidrug-resistant organisms: A retrospective study.Virulence,2024,15(1):2356680-2356680.
[13] Zhu QQ, Chen BF, Yang Y ,et al.Endoscopic ultrasound-guided biliary drainage vs percutaneous transhepatic bile duct drainage in the management of malignant obstructive jaundice.World J Gastrointest Surg, 2024 ,16(6):1592-1600.
[14] Li M, Yu K, Deng D ,et al.CT guided percutaneous drainage for left hepatic subcapsular hematoma after endoscopic retrogradecholangiopancreatography.Rev Esp Enferm Dig, 2023 ,115(11):655-656.
[15] 王雪梅,张瑶,杨学平,等. 超声引导下经皮肝穿刺抽脓法和置管引流法治疗艾滋病并发肝脓肿患者临床效果分析. 实用肝脏病杂志,2021,24(4):573-576.
[16] 林广荣,陈维荣,徐志杰,等. 超声引导下经皮穿刺置管引流治疗肝脓肿临床疗效分析. 中华临床医师杂志(电子版),2017,11(15):2083-2086.
[17] Xin Z , Ultrasound DO .Comparative observation of the effect of percutaneous puncture catheter drainage and laparoscopic hepatic abscess incision drainage on bacterial liver abscess.Modern Med Imageol, 2019,28(4):785-786.
[18] Formanchuk T, Lapshyn H, Voznyuk O ,et al.Percutaneous ultrasound-guided puncture and catheter drainage methods in the treatment of fluid collections following acute pancreatitis.Wiad Lek, 2021,74(8):1794-1799.
[19] Ahmed SU , Rana SS , Sharma RK ,et al.Su1316 safety and efficacy of endoscopic ultrasound guided drainage of liver abscess: An experience of a decade.Gastrointest Endosc, 2020, 91(6):328-328.
[20] Zhang T, Huang X, Xu T, et al. Pyogenic liver abscess caused by extended-spectrum beta-lactamase-producing hypervirulent Klebsiella pneumoniae diagnosed by third-generation sequencing: a case report and literature review.J Int Med Res, 2023, 51(10):3000605231206296.

超声引导穿刺引流治疗细菌性肝脓肿患者疗效研究^*

Intrapurulent catheter drainage under ultrasound guidance in the treatment of patients with bacterial liver abscess

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