【摘要】 目的探讨腹腔镜肝脓肿切开引流术的适应证与疗效。方法对外科处理的101例肝脓肿病例资料进行回顾性分析,比较腹腔镜肝脓肿切开引流与其他外科方法的疗效。结果本组B超或CT引导下穿刺置管引流46例,剖腹脓肿切开引流43例,腹腔镜脓肿切开引流12例。腹腔镜脓肿切开引流组与剖腹手术组相比,手术时间短[(105±17)min vs(137±27)min]、住院费用少[(1.4±0.3)万元vs(1.8±0.6)万元],且住院时间在三组中最短[(9.3±2.1)d vs(15.1±4.4)d及(16.5±4.8)d](P<0.05)。另外,腹腔镜脓肿切开引流组的并发症发生率和复发率均为0,明显低于穿刺置管引流组(28.3%和15.2%)及剖腹脓肿切开引流组(32.6%和4.7%)(P<0.01),同时该组手术死亡率为0,低于穿刺置管引流组(4.3%)及剖腹脓肿切开引流组(7.0%),但差异无统计学意义。结论腹腔镜脓肿切开引流是治疗肝脓肿的有效外科方法之一。更多还原

【Abstract】 Objecive To explore the indication and curative effect of laparoscopic drainage for liver abscess.Methods The data from 101 patients with liver abscess after surgical manipulation were analyzed retrospectively,and the outcome of laparoscopic drainage were compared with those of percutaneous transhepatic drainage(PATD) and laparoscopic surgical drainage(LSD).Results Among 101 patients with liver abscess,46 patients were treated with sonography or computerized tomography-guided PATD 43 patients with LSD and 12 patients with laparoscopic drainage.Compared with LSD,the operation time [(105±17)min vs(137±27)min] was shorter and hospitalization expense(1.4±0.3 vs 1.8±0.6 ten thousands yuan) was less,and the hospital stay period was the shortest among those in three treating groups [(9.3±2.1)d vs(15.1±4.4)d and(16.5±4.8)d](P<0.05).Moreover,the postoperative complication rates and the postoperative recurrence in the laparoscopic drainage group were naught.It was significantly lower than those in PATD group(28.3% and 15.2%) and LSD group(32.6% and 4.7%)(P<0.01).Whereas,there was no operative death case in laparoscopic drainage group,which was less than those in PATD(4.3%) and LSD(7.0%) group,but had no statistic difference.Conclusions Laparoscopic drainage is one of efficient surgical alternatives for treatment of liver abscess.更多还原