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首页> 外文期刊>Journal of Clinical Medicine Research >Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?
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Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

机译：电脑断层扫描引导纸饰：床边腹向床边有效替代品吗？

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Background: Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis.Methods: The period of study was from 2002 to 2012. All patients with cirrhosis who underwent therapeutic paracentesis were included in the study. These patients were divided into two groups. Group I consisted of patients who underwent CT-guided pigtail catheter insertion with ascitic fluid drainage. Group II consisted of patients who underwent beside therapeutic paracentesis after localization of fluid either by physical examination or sonographic localization. We measured the efficacy of CT-guided paracentesis and bedside paracentesis in terms of volume of fluid removed, length of stay, discharge doses of diuretics (spironolactone and furosemide) and number of days to readmission for symptomatic ascites. We also computed the cost-effectiveness of CT-guided therapeutic paracentesis when compared to a bedside procedure. Fischer exact test was used to analyze the distribution of categorical data and unpaired?t-test was used for comparison of means.Results: There were a total of 546 unique patients with diagnosed cirrhosis who were admitted to the hospital with symptomatic ascites and underwent therapeutic paracentesis. Two hundred and forty-seven patients underwent CT-guided paracentesis, while 272 patients underwent bedside paracentesis. There was significant inverse correlation between the amount of ascitic fluid removed and total length of stay in the hospital. We found that the volume of fluid removed via a CT-guided pigtail insertion and drainage (2.72 ± 2.02 L) is significantly higher when compared to fluid removed via bedside paracentesis (1.94 ± 1.69). We also found that the interval time period between two successive therapeutic paracenteses was significantly longer for CT group (106.56 ± 75.2 days) when compared to the bedside group (25.57 ± 7.68 days).Conclusion: CT-guided paracentesis with pigtail catheter insertion and drainage is a clinically effective, cheap and safe alternative to conventional bedside paracentesis.J Clin Med Res. 2017;9(2):92-97doi: https://doi.org/10.14740/jocmr2832w
机译：背景：腹水仍然是失代偿性肝硬化患者住院病的最常见原因。 Paraceides是一种相对安全的程序，具有低并发症率。电脑断层扫描（CT） - 指导的治疗副护搏物可能是一个安全有效的替代方案，可以是无辅助或辅助（超声波标引导）床边腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔腹腔气囊。在这项回顾性研究中，我们旨在比较CT引导腹腔饼干的疗效，安全性和成本效益与床头边缘。方法：学习期为2002年至2012年。所有接受治疗腹腔内患者的肝硬化患者都包含在内研究。将这些患者分为两组。小组由患者组成，患者接受了CT引导的猪尾导管插入腹水排水。第II组由患者组成，患者在通过体检或超声定位局部局部定位液体后患者。我们测量了CT引导的腹腔气囊和床头前腹向腹腔腹腔腹腔的疗效，在移除的流体量，停留长度，利尿剂（螺旋酮和呋塞胺）的储存长度，以及对症状腹水的阅览的天数。与床头手术相比，我们还计算了CT引导治疗性腹腔探伤的成本效益。 Fischer精确测试用于分析分类数据的分布和未配对的ΔT检验用于比较方式。结果：总共有546名独特的肝硬化患者，患有症状腹水和接受治疗腹腔气囊。第二百47例患者进行CT引导下穿刺，而272例患者均行床边放腹水。除去腹水的量与医院住院的总长度之间存在显着的反向相关性。我们发现，与通过床侧腹腔气囊（1.94±1.69）除去的流体相比，通过CT引导的猪尾插入和排水（2.72±2.02L）除去的流体量明显更高。我们还发现，与床头群（25.57±7.68天）相比，CT组（106.56±75.2天）的两个连续治疗性围绕的间隔时间较长。结论：CT引导腹腔带有辫子导管插入和排水是传统床边副护墙的临床有效，便宜和安全的替代品。 2017; 9（2）：92-97DOI：https：//doi.org/10.14740/jocmr2832w

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