儿童阑尾周围脓肿超声引导下经皮脓肿穿刺引流联合抗生素治疗与单用抗生素治疗的疗效对比分析

Comparative Analysis of the Efficacy of Ultrasound-Guided Percutaneous Abscess Drainage Combined with Antibiotic Therapy Versus Antibiotic Therapy Alone in Pediatric Periappendiceal Abscess Management

摘要: 目的：研究分析超声引导下脓肿穿刺引流联合抗生素治疗与单用抗生素治疗在儿童阑尾周围脓肿的疗效及可行性。方法：收集重庆医科大学附属儿童医院2022年12月至2025年4月所有经超声或CT诊断为阑尾周围脓肿的患儿临床病历资料。将所有收集到的病例分为脓肿穿刺引流组和单用抗生素组，使用统计学方法分析各组的指标。结果：本研究共纳入了30例患儿，其中脓肿穿刺引流组15例(50.0%)，两组间的入院时CRP (93.43 ± 55.92 vs 57 ± 30.05 mg/L)、入院时脓肿大小(8.1 vs 5.0 cm)、住院天数(12.0 ± 2.80 vs 15.67 ± 3.58天)、WBC恢复正常天数(7.27 ± 3.33 vs 15.67 ± 3.58天)、脓肿减小速率(0.42 vs 0.19 cm/天)的差异均有统计学意义。其中，脓肿穿刺引流组的入院时CRP、入院时脓肿大小、脓肿消除速率均显著高于单用抗生素组，而住院天数及WBC恢复正常天数均显著短于单用抗生素组。结论：超声引导下阑尾周围脓肿穿刺引流联用抗生素治疗组的病例的脓肿减小速率要明显高于单用抗生素组，明显缩短住院时间。超声引导下脓肿穿刺引流联合抗生素是儿童阑尾周围脓肿安全高效的治疗选择，但其临床应用需严格把握适应证，并依托多学科协作优化诊疗流程。

Abstract: Objective: To investigate and compare the efficacy and feasibility of ultrasound-guided percutaneous abscess drainage combined with antibiotic therapy versus antibiotic therapy alone in the management of pediatric periappendiceal abscess. Methods: Clinical data of pediatric patients diagnosed with periappendiceal abscess via ultrasound or CT between December 2022 and April 2025 were retrospectively collected. Cases were categorized into two groups: the percutaneous drainage group (combined with antibiotics) and the antibiotics-only group. Statistical analyses were performed to compare clinical outcomes between the groups. Results: A total of 30 patients were enrolled, including 15 (50.0%) in the drainage group. Statistically significant differences were observed in the following parameters: baseline C-reactive protein (CRP) levels (93.43 ± 55.92 vs. 57 ± 30.05 mg/L), initial abscess size (8.1 vs. 5.0 cm), hospital stay duration (12.0 ± 2.80 vs. 15.67 ± 3.58 days), time to white blood cell (WBC) count normalization (7.27 ± 3.33 vs. 15.67 ± 3.58 days), and abscess reduction rate (0.42 vs. 0.19 cm/day). The drainage group exhibited significantly higher baseline CRP levels, larger initial abscess size, and faster abscess reduction rate compared to the antibiotics-only group, while demonstrating shorter hospital stays and quicker WBC normalization. Conclusion: Ultrasound-guided percutaneous abscess drainage combined with antibiotics achieves a significantly faster abscess resolution rate and reduces hospitalization duration compared to antibiotic therapy alone in pediatric periappendiceal abscess management. This combined approach represents a safe and effective therapeutic option, though its clinical application requires strict adherence to clinical indications and multidisciplinary collaboration to optimize diagnostic and therapeutic protocols.