ABSTRACT
Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,
ABSTRACT
Objective To investigate the short term effect of licartin transarterial infusion in combination with chemoembolization (LTACE) and compare its effect with conventional transcatheter arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC).Methods Seventy-two cases of advanced HCC were included in this analysis.There were 50 males and 22 females with the average age of (58±12) yrs (range 34-86 yrs).Twenty-nine patients received LTACE treatment while the other forty three patients received conventional TACE treatment.Before intervention,there was no variation (P>0.05) in gender (X2 =0.202),Child-Pugh grading for hepatic function (X2=2.428),as well as in white blood cell count (t=1.101)and platelet count (t =0.080) between the two groups except for age and portal vein thrombosis.For LTACE group,30 minutes after the infusion of licartin (27.75 MBq/kg) into proper hepatic artery,an emulsion of 40 rag pharmorubicin and 30 ml uhrafluid lipidol was infused until hemostasis within target artery.For TACE group,only an emulsion of 40 nag pharmorubicin and 30ml uhrafluid lipidol was infused until hemostasis within target artery.Following these interventions,the two groups were given the same treatment to stabilize hepatic function and relief embolization-relating symptoms; Patients' follow-up included clinical symptoms and signs,hepatic and renal function,peripheral blood test,CT and radionuclide study(ECT).All data were analyzed with SPSS 11.5.Measurement data were expressed with mean and processed by t test; numeration data were processed by Chi square test and Fisher precise test; Kaplan-Meier analysis and log-rank test were applied for comparing the survival rate of the two groups.P <0.05 means the exist of a statistic variation.Results After treatment,there was no variation of Albumin,GPT,serum bilirubin,white blood cell,platelet and serum creatinine level between the two groups [t=0.250,0.907,0.629,0.005,0.250,0.453 (7 days) and 0.978,1.250,1.942,0.733,0.315,1.243 (14 days); P >0.05].ECT imaging demonstrated a 55.17% (16/29) uptake ratio of licartin within tumor areas by the time of 7-days follow-up study.The lesions in both LTACE and TACE groups exhibited a decrease in their size and statistically significant difference was demonstrated before and after treatment in either group( t=7.207,8.006,P <0.01).But between the two groups,the tumor size reduction showed no statistical difference,the tumor size in LTACE and TACE groups were( 1.68±0.32),(1.74±0.31)respectively (t =0.786,P>0.05)before treatment and(1.52±0.38),(1.61±0.36) respectively(t=0.891,P>0.05) after treatment.There was no variation between the two groups comparing the 6 months cumulative survival rate(LTACE 52%,TACE 76%,log-rank test,X2=3.080,P >0.05).Conclusion There was no statistically significant differences between LTACE and TACE groups concerning the short term effect and adverse reaction for treatment of advanced HCC.The long term outcomes should be established on the basis of a large-sample,multiconter,randomized trail.