目的：总结老年性细菌性肝脓肿的多层螺旋CT（MSCT）影像学特征及其治疗方法。方法回顾性分析2001年3月至2014年2月在灌南县中医院确诊为老年性细菌性肝脓肿的42例患者的临床资料，总结MSCT影像学特征及临床治疗特点。组间比较采用t检验。结果42例患者中，37例病灶位于肝右叶，5例位于肝左叶；33例为单发病灶，9例病灶表现为多房或蜂窝状征象。MSCT平扫结果示，病灶均表现为较正常肝组织低的低密度灶，CT值约6～40 Hu；动脉期：39例病灶边缘环状强化，3例病灶边缘无强化。内科保守治疗15例，穿刺引流27例。15例行内科保守治疗的患者脓腔直径（3．7±2．1）cm，发热时间为（11．7±4.1） d，平均住院（22．6±5．3）d；27例行穿刺引流治疗的患者脓腔直径（6．3±2．8）cm，发热时间为（7．1±2．2）d，平均住院（13．7±3．1） d，两组比较差异均有统计学意义（P值分别为0．021、0．026、0．006）。结论 MSCT检查能够准确显示脓肿位置、形态，结合患者病史可做出正确的诊断。B超或CT引导下穿刺引流治疗是一种有效、微创、安全的治疗方法，可有效控制发热，加快老年患者恢复。%Objective To review the multislice computed tomography (MSCT)characteristics and treatment of pyogenic liver abscess in elderly patients.Methods A retrospective analysis was performed on the clinical data of 42 elderly patients who were diagnosed with pyo-genic liver abscess in our hospital from March 2001 to February 2014.The MSCT characteristics and clinical treatment of this disease were reviewed.Comparison between two groups was made by t test.Results Among the 42 patients,37 had the liver abscess in the right lobe, and 5 in the left lobe;33 had single lesions,and 9 had grid-or honeycomb-like lesions.MSCT scan showed that all lesions had a lower density compared with normal hepatic tissues,and the CT values were approximately 6 -40 Hu.In the arterial phase,39 patients had le-sions with peripheral rim enhancement,and 3 had no edge enhancement.Conservative treatment was given to 15 patients,among whom the diameter of abscess was 3.7 ±2.1 cm,the duration of fever was 11.7 ±4.1 d,and the average hospital stay was 22.6 ±5.3 d.Percutane-ous drainage was performed in 27 patients,among whom the diameter of abscess was 6.3 ±2.8 cm,the duration of fever was 7.1 ±2.2 d, and the average hospital stay was 13.7 ±3.1 d.There were significant differences in the diameter of abscess,the duration of fever,and the length of hospital stay between the two groups (P=0.021,0.026,and 0.006,respectively).Conclusion MSCT can accurately reveal the location and morphology of abscess,and correct diagnosis can be made in combination with the patient's medical history.Drainage guided by ultrasound or CT is an effective,minimally invasive,and safe treatment for controlling fever and promoting fast recovery in the elderly.
展开▼
