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我院自1994年1月以来尝试用普通探头引导穿刺治疗肝脓肿23例,取得较好的效果,现报道如下。 23例病人均为我院1994年1月～1998年2月经临床和B超确诊的肝脓肿住院病人,23例患者脓腔共25个,脓腔直径20～85mm,共穿刺26次,进针距离37～80mm,其中直径25～85mm,脓腔21个,穿刺21次,成功率100％;直径25mm以下脓腔4个,穿刺5次,成功率80％。穿刺26次总成功率96.2％。 方法:采用日产EUB-405型超声诊断仪,探头频率3.5MHz,患者术前常规检查出凝血时间。血小板计数、凝血酶元明显,做普鲁卡因试验。取仰卧位,对肝脏进行B超常规探查,查明脓腔位置大小后,把一条细橡皮筋套在探头上,声像图上即可见橡皮筋细小的声影,确认声影在脓腔径线最大,距体表最近,又能避开胆管和大血管的部位引以此为中心稍用力做十字交叉探查法,皮肤上遗留“十”字痕迹,此痕迹即为穿刺点,测量体表至脓腔中心的距离为进针深度;观察橡皮筋声影与体表多方位的夹角,以预定进针角度。由穿刺操作者局部消毒皮肤,铺巾,局麻下将普通穿刺针刺入皮下,按探头所预定角度前进。同时,探头在穿刺旁开100mm处进行监视穿
Our hospital since January 1994 try to use ordinary probe guiding the treatment of liver abscess in 23 cases, achieved good results, are reported below. 23 patients were hospitalized patients with liver abscess diagnosed by clinical and B-ultrasound from January 1994 to February 1998 in our hospital. Twenty-five of the 23 patients had abscess and the diameter of abscess was 20-85 mm. A total of 26 punctures The distance from 37 to 80mm, diameter 25 ~ 85mm, abscess 21, puncture 21 times, success rate 100%; diameter 25mm abscess 4, puncture 5 times, the success rate of 80%. 26 times the puncturing assembly success rate of 96.2%. Methods: Nissan EUB-405 ultrasonic diagnostic apparatus, probe frequency 3.5MHz, the patient routinely check the clotting time. Platelet count, thrombin significantly, do procaine test. Supine position, the liver B-conventional exploration to identify the location of abscess cavity size, put a thin rubber band in the probe, the sonogram can be seen on the small rubber shadow, to confirm the sound shadow in the abscess cavity diameter The largest line from the body surface recently, but also to avoid the parts of the bile duct and large blood vessels to take this as the center slightly harder to do cross-probe method, the skin left “10” word marks, this trace is the puncture point, measuring body surface To the center of abscess distance into the needle depth; observe the rubber band sound and multi-angle body surface angle to the predetermined needle angle. The puncture operator by the local disinfection of the skin, shop towels, local anesthesia will pierce the general puncture needle subcutaneous, according to the predetermined angle probe forward. At the same time, the probe in the puncture to open 100mm at the monitoring wear