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目的探讨肝包虫囊肿细菌感染病原菌分布、影像学表现及超声引导下穿刺不同处理措施对治疗疗效的影响,为肝包虫囊肿细菌感染的临床治疗提供参考依据。方法收集2013年1月-2015年12月在医院行超声引导下穿刺治疗94例肝包虫囊肿细菌感染患者临床资料,均在术前行超声影像学检查及超声引导下穿刺治疗,比较不同感染分期患者影像学表现。结果 94例患者共培养出48株病原菌,以大肠埃希菌为主,共32株占66.67%;感染前期患者84.62%囊肿张力偏低,感染期患者91.53%囊壁塌陷、化脓期患者83.33%囊壁张力高、感染后期患者100.00%囊壁张力低;硬化剂为无水乙醇时治愈率为100.00%高于高渗盐水的治愈率80.95%(P<0.05)。结论大肠埃希菌是引起肝包虫囊肿细菌感染的主要病原菌,囊肿感染分期不同时影像学表现各有特点,超声引导下穿刺治疗时选用无水乙醇治疗效果明显优于高渗盐水。
Objective To investigate the distribution of bacterial pathogens in hydatid cysts, the imaging findings and the effects of ultrasound-guided puncture treatment on the curative effect, and to provide a reference for the clinical treatment of hepatic hydatid cyst bacterial infection. Methods Clinical data of 94 patients with bacterial infection of hepatic hydatid cyst were collected from January 2013 to December 2015 in our hospital. Ultrasound imaging and ultrasound-guided puncture were performed preoperatively to compare different infections Staging of patients with imaging findings. Results A total of 48 strains of pathogenic bacteria were co-cultivated in 94 patients, of which Escherichia coli mainly accounted for 66.67%. 84.62% of the patients in the pre-infection period had low cyst tension, 91.53% of the wall collapsed in the infected patients and 83.33% The cystic wall tension was high, and 100.00% cyst wall tension was lower in the later stage of infection. The cure rate was 100.00% when the hardener was absolute ethanol was 80.95% (P <0.05) higher than that of hypertonic saline. Conclusions Escherichia coli is the main pathogen causing bacterial infection of hydatid cysts. The manifestations of different stages of cyst infection are characterized by different imaging features. Ultrasound-guided percutaneous ethanol treatment is superior to hypertonic saline in the treatment of puncture.