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題名 | Percutaneous CT-Guided Custom-Designed One-Step Abscess Drainage in Critically-Ill Patients=自裝式一次完成穿刺針應用於病危病患的電腦斷層導引經皮膿瘍引流術 |
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作者 | 葉子成; 龔顯琦; 熊小澐; 陳素瓊; 陳加興; 何永仁; 蘇友吉; 黃振義; 李三剛; Yeh, Tzu-chen; Shen, Shen-chyi; Hung, Siu-wan; Chen, Su-chieng; Chen, Jia-shen; Ho, Yung-jen; Su, Yeou-gie; Hwang, Jen-i; Lee, San-kan; |
期刊 | 中華放射線醫學雜誌 |
出版日期 | 19980200 |
卷期 | 23:1 1998.02[民87.02] |
頁次 | 頁7-13 |
分類號 | 416.13 |
語文 | eng |
關鍵詞 | 膿瘍電腦斷層; 膿瘍經皮引流; 電腦斷層; 導引; Abscess CT; Abscess percutaneous drainage; CT guidance; |
中文摘要 | 許多病危病患常合併有腹腔、後腹腔或骨盆腔之膿瘍,可能起因於外科手術後之併發症、胰臟炎、闌尾炎、結腸憩室炎、或克隆氏病之併發膿瘍等,而經皮膿瘍引流是於病危情況下之治療選擇。為縮短病危病患離開加護病房接受治療之時間,電腦斷層導引經皮膿瘍引流術是經常使用之方法。本文之目的是使用一般之侵入性引流器具(如經皮空肝膽道引流之穿刺針、經皮腎臟引流之導管),發展出一次完成的穿刺針,可減少電腦斷層的使用次數、節省使用導線及更換導管之步驟,進而縮短檢查時間,在病危病患經常無法配合之下,此一設計有利於完成引流,同時降低病患離開加護病房時之可能危險性。我們蒐集22例於電腦斷層顯示有腹腔、後腹腔或骨盆腔膿瘍, 使用我們自行發發之一次完成穿刺針,其中20 例接受電腦斷層導引經皮膿瘍引流術,2例藉術前之完整電腦斷層檢查避免不必要之穿刺,成功率為95%,出現併發症之比率為10%,平均一次引流之所需時間為24分鐘。我們並詳述檢查步驟及併發症的預防與處理。 |
英文摘要 | To design an instrument for one-step percutaneous abscess drainage (PAD) to shorten the duration of computed tomography (CT)-guided procedure for patients in critical condition. A custom-designed one-step instrucment was designed as a combination of a percutaneous nephrostomy pigtail catheter and a puncture needle. In twenty-two critically-ill patient, 22 CT-guided drainage procedures were performed in 19 cases with intraabdominal, retroperitoneal, or pelvic abscesses. Drainage procedures were cancelled in two cases as a result of preoperation CT study. One cases failed due to a complicated iatrogenic pneumothorax. The custom-designed drainage combinations facilitated the abscess drainage procedures in critically-ill patients. The average duration for one drainage procedure had been shortened to less than 25 minutes with special care taken for the techniques needed to locate the position and direction of drainage catheter. The overall success and complication rates were 95% and 10%, respectively. Percutaneous CT-guided one-step drainage may provide a more efficient and safer method than sonography-or fluoroscopy-guided procedures in treating critically-ill patients with abscess formations. Custom-designed one-step drainage instrument fulfills both clinical and economic requirements, as compared with the commercial one-stick design. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。