摘要
目的探讨近年来细菌性肝脓肿的临床特点、病原学、诊断和治疗的变化。方法回顾性分析1986年1月—2010年6月北京协和医院118例细菌性肝脓肿住院患者的临床资料。结果 118例平均年龄53.3岁,其中发热(97.5%)、寒战(91.5%)、右上腹痛(44.1%)是最常见的临床表现。糖尿病(41.5%)、胆系疾病(24.6%)是主要易患因素。绝大多数患者外周血白细胞增高(104例),红细胞沉降率增快(62例)。肝右叶(93例)单发脓肿(88例)最多见。21例脓液培养和55例血培养阳性,肺炎克雷伯菌是最主要病原菌,占56.4%。80例经B超或CT引导下穿刺引流并联合抗生素治疗。死亡3例,总有效率为96.6%。结论细菌性肝脓肿患者的平均患病年龄有增大趋势,以肝右叶单发脓肿最常见,且临床表现多样,病原学以肺炎克雷伯菌最常见,糖尿病和胆系疾病是主要的易患因素。
Objective To investigate the clinical features, pathology, diagnosis and treatment of patients with pyogenic liver abs-cesses. Methods Clinical data of 118 patients with pyogenic liver abscesses, admitted to Peking Union Medical College Hospital from Jan. 1986 to Jun. 2010, were analyzed retrospectively. Results The mean age of 118 patients was 53.5 years. They were mainly manifested with fever （97.5%）, chills （91.5%） and right upper quadrant pain （44.1%）. Patients with diabetes （41.5%） and biliary diseases （24.6%） were the most likely to develop pyogenic liver abscesses. An elevated white blood cell count was seen in 104 pa- tients and an elevated erythrocyte sedimentation rate in 62 patients. The abscesses in the right lobe were found in 93 patients, and the abscesses of 88 patients were solitary. Twenty-one purulent secretion cultures and 55 blood cultures were bacteriologically positive. Klebsiella pneumonia was identified in 56.4% of the patients. Eighty patients received ultrasound B or CT-guided percutaneous drainage combined with antibiotic therapy. Three patients died and the total effectiveness rate was 96.6%. Conclusions The mean age of the patients with pyogenic liver abscesses tends to rise. Solitary abscesses in the right lobe are commonly seen with diverse manifestations. Klebsiella pneumonia is the most common pathogen, and diabetes and biliary diseases are the major risk factors for pyogenic liver abscesses.
出处
《传染病信息》
2011年第2期79-81,共3页
Infectious Disease Information
基金
中华医学会临床医学科研专项资金-重症医学领域感染研究资金项目
关键词
肝脓肿
细菌
体征和症状
治疗学
liver abscesses
bacteria
signs and symptoms
therapeutics
