超声介入治疗不典型肝脓肿的效果及预后分析OA

Objective To compare the clinical efficacy and prognostic outcomes of ultrasound-guided percutaneous needle aspiration(PNA)and percutaneous catheter drainage(PCD)in the treatment of atypical liver abscess.Methods This retrospective study included 90 patients with atypical liver abscess admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2021 to June 2024.According to the interventional drainage technique,the patients were assigned to the PNA group(n=42)and the PCD group(n=48).On the basis of broad-spectrum antibiotic therapy,patients in the two groups received PNA or catheter-based PCD drainage,respectively.Postoperative changes in liver function indices[aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBil)]and inflammatory indices[C-reactive protein(CRP),procalcitonin(PCT),and systemic immune-inflammation index(S Ⅱ)]were monitored and compared at 7 days,1 month,and 12 months after the procedure.Clinical efficacy was evaluated,and complications were recorded.Results At 1 month after treatment,the PCD group had a higher proportion of markedly effective cases(75.00%vs 54.76%)and a lower proportion of ineffective/relapsed cases(2.08%vs 9.52%).The distribution of treatment responses differed significantly between the two groups(P＜0.05).Before treatment,there were no statistically significant differences between the two groups in CRP,PCT,or SⅡ levels(P＞0.05).Repeated-measures analysis of variance showed significant main effects of time for all indices(P＜0.05),indicating that levels decreased significantly over time after treatment.Pairwise comparisons showed that the reductions in CRP,PCT,and S Ⅱ at 7 days after treatment were significantly greater in the PCD group than in the PNA group(P＜0.05),whereas no statistically significant differences were observed between the two groups at 1 month and 12 months after treatment(P＞0.05).Before treatment,there were no statistically significant differences between the two groups in AST,ALT,or TBil levels(P＞0.05).Repeated-measures analysis of variance showed significant main effects of time for all liver function indices(P＜0.05),indicating significant decreases over time after treatment.In addition,significant time-by-group interaction effects were observed for all three indices(P＜0.05).Pairwise comparisons showed that the reductions in AST,ALT,and TBil at 7 days after treatment were significantly greater in the PCD group than in the PNA group(P＜0.05),whereas no statistically significant differences were found between the two groups at 1 month and 12 months after treatment(P＞0.05).Moreover,the main effects of group were not statistically significant for these three indices(P＞0.05).During follow-up after treatment,in the PNA group,4 patients experienced recurrence of liver abscess and 2 patients developed bleeding,with a complication rate of 14.29%(6/42).In the PCD group,1 patient experienced recurrence of liver abscess and 2 patients reported abdominal pain,with a complication rate of 6.25%(3/48).The difference in complication rates between the two groups was not statistically significant(χ²=0.838,P=0.360).Conclusion For atypical liver abscess,both ultrasound-guided PNA and PCD on the basis of standardized antibiotic therapy can achieve favorable efficacy and long-term prognosis.PCD can provide continuous drainage of pus,accelerate infection control and recovery of liver function,and improve the short-term markedly effective rate.