Abstract：
We aimed to compare the results of image-guided drainage in addition to antibiotic therapy (antibiotherapy) with antibiotherapy alone in the treatment of tubo-ovarian abscesses (TOAs) and evaluate C-reactive protein (CRP) levels in predicting the success of antibiotherapy.
This was a retrospective study of 194 patients hospitalized with TOA. Patients were divided into the following two groups: those who underwent image-guided drainage in addition to parenteral antibiotherapy and those who did not undergo image-guided drainage and received antibiotherapy alone. CRP levels on the day of admission (day 0), day 4 of hospitalization (day 4), and day of discharge (last day) were recorded. The percentage of decrease in CRP levels during day 4 and the last day compared with that on day 0 was calculated.
A total of 106 patients (54.6%) underwent image-guided drainage with antibiotherapy, whereas 88 patients (45.4%) did not undergo drainage and received antibiotherapy alone. At admission, the mean CRP level was 203.4 (± 96.7) mg/L and was similar in both groups. The mean decrease in the CRP level on day 4 compared with that on day 0 was 48.5% and was statistically higher in the group that underwent image-guided drainage. Antibiotherapy failed in 18 patients, and a statistically significant difference was observed between treatment failure and the rate of decrease in the CRP level on day 4 compared with that on day 0. According to the receiver operating characteristic (ROC) analysis, if the CRP level measured on day 4 decreased by < 37.1% compared with that on day 0, the probability of treatment failure would increase (area under the curve = 0.755; 95% confidence interval, 0.668-0.841; sensitivity, 73.6%; specificity, 60%).
Image-guided drainage combined with antibiotherapy in the treatment of TOA has high success rates, lower recurrence rates, and lower surgical requirement, and the mean decrease in the CRP level on day 4 can be monitored at treatment follow-up. In patients receiving antibiotherapy alone, if the CRP level on day 4 decreases by < 37.1%, the treatment protocol should be changed.
This was a retrospective study of 194 patients hospitalized with TOA. Patients were divided into the following two groups: those who underwent image-guided drainage in addition to parenteral antibiotherapy and those who did not undergo image-guided drainage and received antibiotherapy alone. CRP levels on the day of admission (day 0), day 4 of hospitalization (day 4), and day of discharge (last day) were recorded. The percentage of decrease in CRP levels during day 4 and the last day compared with that on day 0 was calculated.
A total of 106 patients (54.6%) underwent image-guided drainage with antibiotherapy, whereas 88 patients (45.4%) did not undergo drainage and received antibiotherapy alone. At admission, the mean CRP level was 203.4 (± 96.7) mg/L and was similar in both groups. The mean decrease in the CRP level on day 4 compared with that on day 0 was 48.5% and was statistically higher in the group that underwent image-guided drainage. Antibiotherapy failed in 18 patients, and a statistically significant difference was observed between treatment failure and the rate of decrease in the CRP level on day 4 compared with that on day 0. According to the receiver operating characteristic (ROC) analysis, if the CRP level measured on day 4 decreased by < 37.1% compared with that on day 0, the probability of treatment failure would increase (area under the curve = 0.755; 95% confidence interval, 0.668-0.841; sensitivity, 73.6%; specificity, 60%).
Image-guided drainage combined with antibiotherapy in the treatment of TOA has high success rates, lower recurrence rates, and lower surgical requirement, and the mean decrease in the CRP level on day 4 can be monitored at treatment follow-up. In patients receiving antibiotherapy alone, if the CRP level on day 4 decreases by < 37.1%, the treatment protocol should be changed.
摘要：
目的：我们的目的是比较图像引导引流术加抗生素治疗（抗生素治疗）与单独的抗生素治疗输卵管卵巢脓肿（TOAs）的结果，并评估C反应蛋白（CRP）水平在预测抗生素治疗成功方面的作用。
方法：这是194例TOA住院患者的回顾性研究。患者分为以下两组：除肠胃外接受抗生素治疗外还接受图像引导引流的患者，以及未接受图像引导引流并仅接受抗生素治疗的患者。入院当天（第0天）的CRP水平，住院第4天（第4天），并记录出院日（最后一天）。计算第4天和最后一天与第0天相比CRP水平降低的百分比。
结果：共有106名患者（54.6%）接受了图像引导引流和抗生素治疗，而88例患者(45.4%)没有接受引流，只接受抗生素治疗。入院时,CRP平均水平为203.4(±96.7)mg/L,两组相似.与第0天相比，第4天的CRP水平平均下降了48.5％，在接受图像引导引流的组中统计学上更高。18例患者的抗生物治疗失败，与第0天相比，第4天治疗失败和CRP水平下降率之间存在统计学上的显着差异。根据接收机工作特性(ROC)分析,如果第4天测得的CRP水平与第0天相比下降<37.1%，则治疗失败的概率会增加(曲线下面积=0.755;95%置信区间,0.668-0.841;灵敏度,73.6%；特异性，60%）。
结论：影像引导引流联合抗菌治疗TOA成功率高，较低的复发率，和较低的手术要求，第4天CRP水平的平均下降可以在治疗随访时监测。在单独接受抗生素治疗的患者中，如果第4天的CRP水平下降<37.1%，治疗方案应该改变.
方法：这是194例TOA住院患者的回顾性研究。患者分为以下两组：除肠胃外接受抗生素治疗外还接受图像引导引流的患者，以及未接受图像引导引流并仅接受抗生素治疗的患者。入院当天（第0天）的CRP水平，住院第4天（第4天），并记录出院日（最后一天）。计算第4天和最后一天与第0天相比CRP水平降低的百分比。
结果：共有106名患者（54.6%）接受了图像引导引流和抗生素治疗，而88例患者(45.4%)没有接受引流，只接受抗生素治疗。入院时,CRP平均水平为203.4(±96.7)mg/L,两组相似.与第0天相比，第4天的CRP水平平均下降了48.5％，在接受图像引导引流的组中统计学上更高。18例患者的抗生物治疗失败，与第0天相比，第4天治疗失败和CRP水平下降率之间存在统计学上的显着差异。根据接收机工作特性(ROC)分析,如果第4天测得的CRP水平与第0天相比下降<37.1%，则治疗失败的概率会增加(曲线下面积=0.755;95%置信区间,0.668-0.841;灵敏度,73.6%；特异性，60%）。
结论：影像引导引流联合抗菌治疗TOA成功率高，较低的复发率，和较低的手术要求，第4天CRP水平的平均下降可以在治疗随访时监测。在单独接受抗生素治疗的患者中，如果第4天的CRP水平下降<37.1%，治疗方案应该改变.
