探讨经腔道内超声造影在置管术后引流不畅患者中的应用价值。

选择2019年12月至2020年6月在复旦大学附属中山医院行超声引导下置管引流且临床认为引流不畅的患者52例纳入研究。采用常规超声及经腔道内超声造影观察引流管体及引流管头端位置，同时评价引流管的引流区域。超声造影剂为SonoVue，以1∶200比例稀释。采用t检验比较经腔道内超声造影与常规超声显示引流管时间的差异，采用χ²检验比较2种方法显示引流管数目的差异。

经腔道内超声造影显示引流管体及引流管头端的时间分别是（5.72±0.83）s及（13.4±1.12）s，明显短于常规超声显示时间：（69.94±7.06）s及（108.50±7.06）s，差异具有统计学意义（t=520.5、840.2，P均＜0.001）。经腔道内超声造影显示的引流管体及引流管头端的比例分别是94.2%（49/52）及88.5%（46/52），优于常规超声的显示率：40.4%（21/52）及21.1%（11/52），差异具有统计学意义（χ²=33.28、47.55，P均＜0.001）。经腔道内超声造影发现6例脓肿存在多脓腔改变，其中置管脓腔与其他脓腔不相交通者4例。

经腔道内超声造影可提供准确的引流管位置及引流管头端信息，并可充分评估引流不畅的原因，从而指导临床调整引流管。

To investigate the value of intracavitary contrast-enhanced ultrasound in examination of drainage tube in patients with poor drainage.

From December 2019 to June 2020, patients who underwent ultrasound-guided percutaneous catheter drainage and were clinically considered to have poor drainage at our hospital were enrolled in the study. B-mode ultrasound and intracavitary contrast-enhanced ultrasound were used to observe the position and tip of the drainage catheter, and the effective drainage areas of the tube was evaluated. The contrast agent was SonoVue diluted 1:200 for intraluminal usage. SPSS statistical software was used for statistical analyses.

The times to detect the drain body and the drain tip by intracavitary contrast-enhanced ultrasound were (5.72±0.83) s and (13.4±1.12) s, respectively, which were significantly shorter than those spent by conventional ultrasonography [(69.94±7.06) s and (108.50±7.06) s, t=520.5 and 840.2, respectively, P＜0.001]. The detection rates of the drain body and drain head by intracavitary contrast-enhanced ultrasound were 94.2% (49/52) and 88.5% (46/52), respectively, which were significantly better than the corresponding rates [40.4% (21/52) and 21.1% (11/52)] achieved by using conventional ultrasound (χ²=33.28 and 47.55, respectively, P＜0.001). Intracavitary contrast-enhanced ultrasound revealed multiple lacunae in six abscesses, including four cases in which the part of the drainage catheter placed in the abscess did not communicate with other abscess parts.

Intracavitary contrast-enhanced ultrasound can provide accurate information about the position of the drainage tube and tip, and can fully evaluate the cause of poor drainage, so as to guide clinicians to adjust the drainage tube.