Clinical efficacy of ultrasound-guided percutaneous catheter drainage in treatment of liver abscess

doi:10.3877/cma.j.issn.1674-0785.2017.15.005

Abstract

Abstract:

Objective

To compare the clinical efficacy of ultrasound-guided percutaneous catheter drainage versus incision and drainage in the treatment of liver abscess.

Methods

Thirty-two liver abscess patients who underwent ultrasound-guided percutaneous catheter drainage from June 2015 to June 2016 at our hospital and 32 liver abscess patients who underwent incision and drainage from January 2014 to January 2015 at our hospital were included in this study. The cure rate, time to recovery of body temperature to normal, time to recovery of white blood cell count, time to extubation, hospitalization length, hospitalization cost, and occurrence of complications were compared between the two groups.

Results

The cure rate was significantly higher in the catheter drainage group than in the incision and drainage group (96.88% vs 84.38%, χ² = 2.94, P>0.05). The time to recovery of body temperature to normal, time to recovery of white blood cell count, time to extubation, and hospitalization length were significantly shorter in the catheter drainage group than in the incision and drainage group [(3.13 ± 1.04) d vs (7.09 ± 1.42) d, (4.06 ± 1.32) d vs (7.28 ± 1.30) d, (10.03 ± 1.18) d vs (14.06 ± 1.16) d, (14.03 ± 1.15) d vs (18.03 ± 1.21) d; t_{=12.197, 9.831, 13.784, 14.091, P<0.05], respectively. The hospitalization cost was significantly less in the catheter drainage group than in the incision and drainage group [(8288.81 ± 355.43) yuan vs (12 771.98 ± 337.93) yuan, t = 51.711, P<0.05]. The complication rate was significantly lower in the catheter drainage group than in the incision and drainage group (3.13% vs 15.63%, χ² = 6.56, P<0.05).}

Conclusion

Ultrasound-guided percutaneous catheter drainage has the advantages of precise and easy operation, mild trauma, quick recovery, and low complication rate over incision and drainage in the treatment of liver abscess.

Key words: Ultrasound-guided, Liver abscess, Catheter drainage, Incision and drainage

Guangrong Lin, Weirong Chen, Zhijie Xu, Gaoyang Cai, Yanchong Li, Peihong Zheng. Clinical efficacy of ultrasound-guided percutaneous catheter drainage in treatment of liver abscess[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(15): 2083-2086.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2017.15.005

https://zhlcyszz.cma-cmc.com.cn/EN/Y2017/V11/I15/2083

Figures/Tables 2

References 19

[1]	Lin YT, Wang FD, Wu PF, et al. Klebsiella pneumoniae, liver abscess in diabetic patients: association of glycemic control with the clinical characteristics [J]. BMC Infec Dis, 2013, 13(1):56.
[2]	Sung CC, Lin CS, Lin SH. Pyogenic liver abscess is associated with increased risk of acute kidney injury: a nationwide population-based cohort study [J]. Medicine(Baltimore), 2016, 95(3):e2489.
[3]	Lardière-Deguelte S, Ragot E, Amroun K, et al. Hepatic abscess: Diagnosis and management [J]. J Visc Surg, 2015, 152(4):231-243.
[4]	Lai SW, Liao KF, Lin CL, et al. Pyogenic liver abscess correlates with increased risk of acute pancreatitis: a population-based cohort study [J]. J Epidemiol, 2015, 25(3):246-253.
[5]	Keller JJ, Kang JH, Sheu JJ, et al. Risk of stroke following diagnosis with pyogenic liver abscess: a nationwide population-based study [J]. Hepatol Int, 2012, 6(4):801-808.
[6]	Huang WK, Lin YC, Chiou MJ, et al. Pyogenic liver abscess as a warning sign for primary liver cancer: a nationwide population-based study [J]. Asian Pac J Cancer Prev, 2013, 14(8):4727-4731.
[7]	杨文雄，康利民，郑永, 等. 细菌性肝脓肿不同治疗方法临床疗效的比较 [J]. 中国医学创新, 2011, 8(12):32-34.
[8]	赵东升. 超声引导经皮穿刺置管引流术与切开置管引流术治疗肝脓肿的疗效比较 [J]. 中国基层医药, 2015, 22(12):1882-1884.
[9]	姚利琴，冯文明，陆文明, 等. 超声引导经皮穿刺置管引流治疗肝脓肿41例临床分析 [J]. 肝胆胰外科杂志, 2011, 23(4):319-320.
[10]	Zerem E, Omerovic S, Kunosic S. Sonographically guided percutaneous treatment of liver abscesses in critically Ⅲ Patients [J]. J Clin Ultrasound, 2014, 9(42):527-533.
[11]	闫楠，高屏，孙健玮. 彩色多普勒超声引导下置管引流治疗细菌性肝脓肿效果分析[J]. 临床与实践, 2016, 14(23):14-15.
[12]	Alkofer B, Dufay C, Parienti JJ, et al. Are pyogenic liver abscesses still a surgical concern?A Western experience [J]. HPB Surg, 2012, 2012:316013.
[13]	Meddings L, Myers RP, Hubbard J, et al. A Population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends [J]. Am J Gastroenterol, 2010, 105(1):117-124.
[14]	Ang TL, Seewald S, Teo EK, et al. EUS-guided drainage of ruptured liver abscess [J]. Endoscopy, 2009, 41(Suppl 2):21-22.
[15]	Alvarez-Uria G, Pakam R, Midde M, et al. Intra-abscess administration of antibiotics through ultrasound-guided percutaneous catheter for the treatment of pyogenic liver abscess [J]. J Clin Diagn Res, 2013, 7(8):1698-1699.
[16]	Chavez-Tapia NC, Hernandez-Calleros J, Tellez-Avila FI, et al. Image-guided Percutaneous procedure plus metronidazole versus metronidazole alone for uncomplicated a-moebic liver abscess [J]. Cochrane Database Syst Rev, 2009, 21(1):48-56.
[17]	蔡翊. B超引导下穿刺置管引流术治疗肝脓肿临床观察 [J]. 中国现代医学杂志, 2013, 23(19):94-96.
[18]	刘玮. 超声引导下经皮穿刺置管引流在肝脓肿治疗中的应用 [J]. 中国当代医药, 2014, 21(30):24-26.
[19]	Ahmed S, Chia CL, Junnarkar SP. Percutaneous drainage for giant pyogenic liver abscessdis it safe and sufficient? [J]. Am J Surg, 2016, 211(1):95-101.

组别	例数	体温恢复正常时间（d）	白细胞计数恢复正常时间（d）	拔管时间（d）	住院总时间（d）	住院总费用(元)
超声组	32	3.13±1.04	4.06±1.32	10.03±1.18	14.03±1.15	8288.81±355.43
手术组	32	7.09±1.42	7.28±1.30	14.06±1.16	18.03±1.21	12 771.98±337.93
t值	?	12.197	9.831	13.784	14.091	51.711
P值	?	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05

组别	例数	体温恢复正常时间（d）	白细胞计数恢复正常时间（d）	拔管时间（d）	住院总时间（d）	住院总费用(元)
超声组	32	3.13±1.04	4.06±1.32	10.03±1.18	14.03±1.15	8288.81±355.43
手术组	32	7.09±1.42	7.28±1.30	14.06±1.16	18.03±1.21	12 771.98±337.93
t值	?	12.197	9.831	13.784	14.091	51.711
P值	?	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05

组别	例数	切口出血	伤口感染	胸腔积液	合计[例数（%）]
超声组	32	1	0	0	1（3.13）
手术组	32	1	3	1	5（15.63）
χ²值	?	?	?	?	6.56
P值	?	?	?	?	＜0.05

组别	例数	切口出血	伤口感染	胸腔积液	合计[例数（%）]
超声组	32	1	0	0	1（3.13）
手术组	32	1	3	1	5（15.63）
χ²值	?	?	?	?	6.56
P值	?	?	?	?	＜0.05

Please choose a citation manager

Content to export