探讨床旁超声引导下经皮穿刺置管引流术（percutaneous catheter drainage，PCD）联合抗生素治疗急重症细菌性肝脓肿的临床效果。

选取90例因细菌性肝脓肿并急性感染性休克行床旁超声引导下PCD的患者为研究对象，记录置管前和置管术后1、3、7 d患者的脓肿最大直径、白细胞计数、中性粒细胞百分比、C-反应蛋白、血清乳酸等，根据细菌培养结果、药敏结果调整抗生素使用，分析比较治疗前后各参数的差异性，另外记录患者置管引流时间、住院时间及并发症等情况，评估治疗效果。

90例患者均顺利完成PCD，操作时间为（53.43±7.77）min。置管术后1、3和7 d患者脓肿最大直径、白细胞、中性粒细胞百分比、C-反应蛋白、血清乳酸均较置管前有好转，差异均有统计学意义（P < 0.05）。术后患者置管引流时间为（7.77±1.46）d，住院时间为（14.71±1.52）d，术后2例出现胆汁漏，其他88例未出现并发症。根据患者是否存在糖尿病分组，结果显示糖尿病组气腔形成的比例更高（26.23% vs 6.90%，χ² = 4.592，P = 0.032）。

床旁超声引导下PCD方便快速，联合针对性抗生素治疗急重症细菌性肝脓肿效果好、并发症少，合并糖尿病时易形成气腔，临床操作中需更加谨慎。

To explore the clinical effects of bedside ultrasound-guided percutaneous catheter drainage (PCD) combined with antibiotics in the treatment of acute and severe bacterial liver abscess.

Ninety patients who underwent bedside ultrasound-guided PCD due to bacterial liver abscess associated with acute septic shock were selected. The maximum diameter of abscess, leukocyte count, percentage of neutrophils, C-reactive protein and serum lactic acid were recorded before catheterization and 1, 3 and 7 days after catheterization. The differences of preoperative and postoperative parameters were analyzed and compared. In addition, the time of drainage, hospital stay and complications were recorded for evaluating the treatment effect.

All of 90 patients were successfully completed PCD, and the procedure time was 53.43 ± 7.77 min. The maximum diameter of abscess, the percentage of leukocytes, neutrophils, C-reactive protein and serum lactic acid in 1, 3 and 7 days after catheterization were better than those before catheterization (P < 0.05). The postoperative drainage time was 7.77 ± 1.46 days, and the hospital stay was 14.71 ± 1.52 days. Bile leakage occurred in 2 cases and no complications occurred in the other 88 cases. According to whether patients had diabetes or not, the results showed that the proportion of air cavity formation was higher in the diabetes group (26.23% vs 6.90%, χ² = 4.592, P = 0.032).

The bedside ultrasound-guided PCD is convenient and fast. There are good effects and few complications for acute and severe bacterial liver abscess when combined with targeted antibiotics. Patients with diabetes are prone to air cavity formation, which need more caution in clinical procedure.