直肠癌患者术后继发盆腔脓肿经CT引导下穿刺引流疗效分析

发布时间：2018-06-05 08:21

  本文选题：盆腔脓肿 + CT引导　； 参考：《中华医院感染学杂志》2015年08期

【摘要】：目的探讨CT引导下经皮穿刺引流直肠癌术后继发盆腔脓肿的可行性、疗效和影响临床疗效的因素,为临床治疗提供参考依据。方法选取2005年5月-2013年8月37例直肠癌术后发生盆腔脓肿,内科保守治疗失败后接受CT引导下经皮穿刺脓肿引流术,采用SPSS16.0软件进行统计分析。结果 CT引导下盆腔脓肿穿刺引流技术临床成功率为100.00%;穿刺置管采用斜路径4例占10.81%、前路径7例占18.92%和后路径26例占70.27%,穿刺置管时间20~90min、导管留置时间0~45d、引流液0~2 500ml;病原菌培养阳性31例,阳性率83.78%,大肠埃希菌是主要致病菌,共30株,占96.78%;临床失败共5例,均接受手术治疗;临床疗效与不同型号的导管(P0.001)和是否存在吻合口瘘(P=0.001)有关;轻微并发症4例,发生率10.81%。结论设计合理的穿刺路径,行CT引导下经皮穿刺引流直肠癌术后继发盆腔脓肿安全、有效,采用≥8F的留置导管、无吻合口瘘临床疗效好。
[Abstract]:Objective to explore the feasibility, curative effect and influencing factors of secondary pelvic abscess after percutaneous puncture drainage under CT guidance, and to provide reference for clinical treatment. Methods from May 2005 to August 2013, 37 cases of pelvic abscess occurred after rectal cancer operation. After the failure of conservative medical treatment, CT guided percutaneous puncture drainage of abscess was performed. SPSS16.0 software was used for statistical analysis. Results the clinical success rate of CT guided drainage technique for pelvic abscess was 100.00.The oblique path was used in 4 cases (10.81%), the anterior pathway was 18.92% (7 cases) and the posterior path was 70.27% (26 cases). The puncture time was 2090 min, the indwelling time was 045 days, and the drainage fluid was 02. Positive culture of pathogenic bacteria in 31 cases, The positive rate was 83.78. Escherichia coli was the main pathogenic bacteria, accounting for 96.78%, 5 cases of clinical failure were treated by surgery, the clinical efficacy was related to the different types of ducts (P0.001) and the existence of anastomotic fistula (P0.001), and slight complications occurred in 4 cases (10.81%). Conclusion it is safe and effective to design a reasonable puncture path and to perform CT guided percutaneous drainage of secondary pelvic abscess after rectal cancer operation. No anastomotic fistula can be obtained by using a indwelling catheter with 鈮，

本文编号：1981319