【摘要】 本文报告我院收治的膈下脓肿93例,其中非手术所致者48例,多见于胆道病,上腹部手术后所致者45例,占同期5269例上腹部手术的0.85％。主要原因为术野污染和液体积聚。全组病死率为21.5％,超声及 X线检查阳性率分别为91.8％和96.6％,对早期病例可用试探性穿刺来确诊。确诊后应及时作有效引流,使用抗生素和全身支持治疗。更多还原

【Abstract】 This article reports 93 cases of subphre-nic abscess from 1974 to 1983, of which 48had a non-operation cause, and the other 45were caused by epigastric laparotomy, ac-counting for 0.85%,of 5,269 cases of the op-eration performed;during the same period. It was remarkable that there was a highincidence in the conditions after drainageprocedure of necrotic pancreatitis, resectionof the hepatic lobe, splenectomy and repair-ment of a perforating ulcer. They were 10%,3.25%, 2.44%,and 2.16% respectively. It was amain cause that operative field was conta-minated and fluid was accumulated. Of the93 cases, 20 patients died, the mortality be-ing 21.5%. We think that when a high fever lastsa week, accompanied with leucocytosis, pal?and tenderness in the upper abdomen, itscause must be considered. We found in thiscondition that the positive results accountedfor 91.8% by ultrasound and 96. 6% by diag-nostic radiology. In general, once there is an adequateoperative indication, punctual measuresshould be taken in the treatment of infectionin the epigastric cavity. It is also importantthat preoperative measures should be taken,and broad-spectrum antibiotics should be usedbefore and after the operation. In addition,the operative field should be free of conta-mination and an effective drainage shouldbe given before the fluid is accumulatedin the field to avoid iatrogenic infection.更多还原