三种不同手术方法治疗细菌性肝脓肿的临床疗效分析(1)
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[摘要] 目的 探讨三种不同方法治疗细菌性肝脓肿的临床效果。 方法 60例细菌性肝脓肿患者根据入院顺序分为三组(A、B、C组)，每组各20例。A组采用B超定位引导下经皮行穿刺抽脓，B组行直接开腹肝脓肿切开引流，C组采用腹腔镜下手术治疗。 结果 治疗后经过3个月的观察，A组与B组的有效率分别为70%和80%，C组的有效率为100%，C组高于A组与B组(P < 0.05)。经过观察与统计，C组患者的平均手术时间、术中平均出血量、体温恢复平均时间与住院时间均少于A、B两组，差异均有统计学意义(均P < 0.05)。 结论 经腹腔镜肝脓肿引流术是治疗细菌性肝脓肿的一种新选择，具有患者创伤小、康复快、住院时间短等优点，从而提高治疗疗效，值得推广应用。
[关键词] 细菌性肝脓肿；腹腔镜；B超；开腹
[中图分类号] R657.3+3 [文献标识码] A [文章编号] 1673-7210(2012)01(c)-0035-02
Clinical analysis of three different operative methods in the treatment of bacterial liver abscess
JIA Jifeng CHEN Peng
Department of Hepatobiliary Surgery, the First People's Hospital of Yueyang City, Hu'nan Province, Yueyang 414000, China
[Abstract] Objective To investigate the clinical effects of three different operative methods in the treatment of bacterial liver abscess. Methods 60 patients with bacterial liver abscess were equally divided into three groups (group A, B, C) under a hospital order, each 20 cases. Group A was treated by the B ultrasound-guided percutaneous puncture, group B was treated by the direct abdominal liver abscess incision and drainage, group C was used the laparoscopic surgery for treating. Results After treatment, the effective rates of group A and B were 70% and 80%, and that was 100% in group C, and there was a significant difference among the three groups (P < 0.05). Through observation and statistics, the average operative time, mean intraoperative blood loss, average body temperature recovery time and hospital stay of the C group were significantly less than those of the group A and B, the differences were statistically significant (all P < 0.05). Conclusion Laparoscopic drainage of liver abscess is the new choice for the treatment of bacterial liver abscess, with faster recovery, shorter hospital stay, etc., so it can improve treatment efficacy, and it should be widely applied.
[Key words] Bacterial liver abscess; Laparoscopy; B ultrasound; Abdominal
细菌性肝脓肿是一种严重的感染性疾病，临床上有畏寒发热、肝肿大、肝区疼痛、白细胞总数升高等表现，诊断多不困难。随着卫生条件的改善，细菌性肝脓肿的发病率逐渐减少，但却是一种严重疾病，必须积极治疗[1]。对目前细菌性肝脓肿治疗，首先采取抗感染、营养支持治疗，对于大的肝脓肿实施行经腹腔切开引流术或B超定位下穿刺置管引流术[2]。近几年，笔者应用三种手术方法治疗肝脓肿，取得不同效果，现报道如下：
1 资料与方法
1.1 一般资料
收集我院肝胆外科2009年3月~2011年2月收治的60例细菌性肝脓肿患者 ......
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