Liver abscess puncture

Treatment of diseases: liver abscess Indication Apply to pus to treat liver abscess or to assist in the diagnosis of the cause. Contraindications Those who have bleeding tendency and abnormal blood coagulation, suspected of liver echinococcosis. Preoperative preparation A cleaning plate, a liver puncture bag, a belly band, a small abrasive band, a sterile glove, a slide, a test tube, a culture bottle, etc. are prepared as needed. Surgical procedure 1, before surgery should be detailed to understand the bleeding tendency, and determine the bleeding time, clotting time (test tube method), platelet count, prothrombin time, if there is an abnormality should be suspended, and then puncture. Blood transfusion type and if necessary, cross-match and prepare blood. 2, should explain the purpose of the puncture to the patient, training the breath holding method (after a deep inhalation, breathe out at the end of the breath). If you have cough or uneasiness, give codeine or diazepam (steady) 1h before surgery. 3, B-ultrasound should be performed before surgery to determine the position, size and extent of the abscess to determine the puncture site, direction and depth of the needle. 4, the patient lying flat, shoulder abduction, elbow flexion, hand placed after the pillow with a large intercostal space, under the waist to lay a belly belt. Routine skin disinfection, sterile towels, local anesthesia. 5. Connect the short needle tube with the puncture needle and clamp it with the vascular clamp (or close the three-way switch path). First, the puncture needle is punctured to the skin, the patient is breathed, and then the puncture needle is inserted into the liver pus cavity according to the direction and depth of the ultrasonic positioning. After the puncture cavity is reached, the patient can breathe shallowly. Connect the 50ml syringe and remove the clamp (or open three-way switch path) to assist the hand-clamp. If the pus is not drawn, the patient will hold the breath, retract the needle to the skin, let the patient breathe for a while, and then press the method to change the direction during the breath hold to puncture and suction, usually limited to 3 times. After the pus is drawn, the pus should be drained as much as possible, and the abscess should be washed repeatedly 3-4 times with antibiotics. For diagnostic liver puncture, a puncture needle without a short hose can be used, followed by a 10 ml syringe, and the puncture can be performed by referring to the above method. 6. After the puncture is completed, the needle is pulled out, and the puncture site should be pressed for a while to prevent bleeding. In the tight band, the local can be pressed with a small sand bag.