摘要
目的 总结分析糖尿病并发肝脓肿（ｓｅｐｔｉｃ ｌｉｖｅｒ ａｂｓｃｅｓｓ ｉｎ ｄｉａｂｅｔｉｃｓ， ＤＬＡ）的临床特点，并探讨其治疗策略。 方法 对ＤＬＡ及同期收治的非糖尿病肝脓肿（ｎｏｎｄｉａｂｅｔｉｃ ｌｉｖｅｒ ａｂｓｃｅｓｓ，ＮＤＬＡ）进行回顾性对比分析。结果 ＤＬＡ主要 发生于老年人，男女患病率相近，而ＮＤＬＡ主要发生于４０岁左右中年人，男多于女（Ｐ＜０．０５）；ＤＬＡ的诱因依次为肺部 感染、结石性胆囊炎、尿路感染，而ＮＤＬＡ依次为胆道系统病变、腹腔手术等；病原学方面，ＤＬＡ主要为肺炎克雷伯杆菌 等Ｇ－杆菌感染，而ＮＤＬＡ则多为金黄色葡萄球菌、大肠杆菌、肺炎克雷伯杆菌等感染；ＤＬＡ治愈率较对照组低（３６．４％ ｖｓ ６７．４％，Ｐ＜０．０５），平均住院时间较对照组长（２９．６±１４．１天ｖｓ １９．１±１２．０天，Ｐ＜０．０５）。结论 糖尿病是肝脓肿重 要的易患因素之一；早期静脉应用足量抗Ｇ－杆菌抗生素控制感染，胰岛素控制血糖以及彻底的手术切开引流，是成功治 疗ＤＬＡ的关键。
Objective To study the clinical characteristics of septic liver abscess in diabetics (DLA) and search for a therapeutic strategy in the hope of improving life quality of the survivors. Methods Medical records of eleven cases with DLA and 46 cases with nondiabetic liver abscess (NDLA) were reviewed critically and retrospectively. Results (1) DLA often occurred in elderly patients,with similar morbidity in both sexes; (2) Predisposing factors of DLA were pulmonary infection, acute cholecystitis, urinary tract infection; while in NDLA, binary tract disorders and intraabdominal operation were contribute factors with 54% patients being cryptogenic; (3)Klebsiella pneumoniae was the major pathogen in DLA and staphylococcus aureus, Escherichia cloi, Klebsiella pneumoniae, etc. were the major pathogens in NDLA; (4)There was no significant difference in clinical manifestations, location of abscess and size of abscess between these two groups; (5)The misdiagnosis rate was higher in DLA than that in NDLA (54.5% vs 25.6%, P<0. 5);(6)The curative ratio was lower in DLA than that in NDLA (36.4% vs 67.4%, P<0. 05 ), the mean hospitalization time was longer in DLA than that in NDLA (29. 6±14. 1 vs 19.1±12. 0 days,P<0. 05). Conclusion (1)Diabetes mellitus was one of the important predisposing factors for pyogenic liver infection; (2) Early and adequate drainage for pyogenic liver abscesses with parenteral antibiotics and insulin are crucial for the improvement of the outcome of the disease.
出处
《中国糖尿病杂志》
CAS
CSCD
2001年第3期167-170,共4页
Chinese Journal of Diabetes
关键词
糖尿病
肝脏
脓肿
治疗
Diabetes Mellitus Liver Abscess
