Comparison Of Curative Effect Of Percutaneous Liver Puncture Drainage And Laparoscopic Drainage In Treatment Of Bacterial Liver Abscess

Objective: To compare the efficacy of percutaneous liver puncture drainage and laparoscopic drainage in the treatment of Pyogenic liver abscess(PLA),and to preliminarily explore the advantages and disadvantages of different PLA treatment methods.Methods: A total of 85 PLA patients admitted and diagnosed in Dalian Central Hospital and the First Affiliated Hospital of Dalian Medical University from January2015 to November 2020 were retrospectively analyzed.According to the treatment methods,they were divided into puncture group and endoscopic group.Forty-three patients in the puncture group received percutaneous catheter drainage(PCD)and 42 patients in the laparoscopic group received laparoscopic surgery(LS).The general information,pathogenic bacteria,clinical manifestations,imaging findings,laboratory examination data before and after surgery,postoperative temperature recovery time,postoperative complication rate,extubation time,treatment effective rate,mortality rate,postoperative length of hospital stay,total hospitalization cost and other data of patients in the two groups were collected.SPSS 22.0 software was used for data analysis.The measurement data conforming to normal distribution and homogeneity of variance were represented by t test(`x±s).The rank sum test was used for non-normal distribution data,and χ2 test was used for counting data comparison.0.05 indicates that the difference is statistically significant.Results: Klebsiella pneumoniae was the most common pathogenic bacteria in PLA,especially in patients with diabetes.The clinical symptoms of PLA patients lack specificity,and imaging examination is the main means of diagnosing PLA.There was no statistical difference in preoperative indicators between the two groups(P>0.05)with comparability.The WBC count and neutrophils percentage in endoscopic group were lower than those in puncture group on the 1st and 3rd day after surgery,and the differences were statistically significant(P<0.05);The time of white blood cells returning to normal was faster in endoscopic group than in puncture group,and the difference was statistically significant(P<0.05).The normal time of body temperature and postoperative extubation time in endoscopic group were earlier than those in puncture group,and the differences were statistically significant(P<0.05).The length of postoperative hospital stay and total hospitalization cost in the puncture group were lower than those in the endoscopic group,and the differences were statistically significant(P<0.05).There was no significant difference in the treatment effective rate and complication rate between the two groups(P>0.05).Conclusion: Both percutaneous hepatic catheter drainage and laparoscopic surgical drainage are effective in the treatment of PLA,both of which have their own advantages and disadvantages.Percutaneous catheter drainage has the advantages of anesthesia,less risk of surgical operation,shorter average postoperative hospital stay,lower cost,and patients can wear the catheter for a long time.Laparoscopic drainage has the advantages of better intraoperative field of vision,adequate drainage of abscess cavity,rapid infection control and short catheter carrying time,but its disadvantages are that it requires general anesthesia,great injury,high cost and long hospital stay.