摘要
目的探讨细菌性肝脓肿(PLA)的临床特征、病原学分布及治疗等情况,为临床诊断与治疗提供依据。方法回顾性分析安徽医科大学第一附属医院2015年3月～2018年6月住院治疗的132例细菌性肝脓肿患者的临床特征、病原学分布及治疗等情况。结果 132例PLA平均年龄(52.70±18.20)岁,以发热(83.33%)、右上腹痛(50.76%)为主要临床表现。完成脓液和血培养并检出细菌92例,其中肺炎克雷伯杆菌50例(54.35%),大肠埃希菌31例(33.70%),金黄色葡萄球菌9例(9.78%),粪肠球菌2例(2.17%)。PLA基础疾病中以胆道疾病(胆结石胆囊炎、胆管炎等)居多,达100例(75.76%);肾脏疾病(肾囊肿、肾功能异常等)90例(68.18%),糖尿病87例(65.91%),高血压72例(54.55%),冠心病27例(20.45%),恶性肿瘤22例(16.67%)。患者入院后均予单纯或联合抗菌药物抗感染治疗,其中有72例(54.55%)例PLA患者单独进行抗菌药物治疗,平均住院时间(37.63±6.08)d;35例(26.52%)患者抗菌药物治疗基础上,同时在CT或超声引导下行经皮穿刺引流,平均住院时间(25.83±5.57)d;抗菌药物治疗基础上外科手术治疗25例(18.94%),平均住院时间(20.44±4.39)d,三组住院时间比较,差异有统计学意义(F=27.8,P<0.05)。结论PLA高发于年龄较大的患者,致病菌主要为肺炎克雷伯杆菌和大肠埃希菌,采用抗菌药物结合穿刺引流能缩短住院时间,疗效较好。
Objective To investigate the clinical features, pathogenic distribution and treatment of bacterial liver abscess (PLA), and to provide evidence for clinical diagnosis and treatment. Methods The clinical characteristics, pathogenic distribution and treatment of 132 patients with bacterial liver abscess who were hospitalized from March 2015 to June 2018 in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. Results The average age of 132 patients was (52.70±18.20) years old.The main clinical manifestations were fever (83.33%) and right upper quadrant pain (50.76%). Completed pus and blood culture and detected 92 cases of bacteria, including 50 cases of Klebsiella pneumoniae (54.35%), 31 cases of Escherichia coli (33.70%), 9 cases of Staphylococcus aureus (9.78%), feces 2 cases of cocci (2.17%). Among the basic diseases of PLA, biliary tract diseases (cholestasis cholecystitis, cholangitis, etc.) are mostly in 100 cases (75.76%);90 cases (68.18%) of kidney diseases (kidney cysts, renal dysfunction, etc.) and 87 cases of diabetes (65.91%), 72 cases (54.55%) with hypertension, 27 cases (20.45%) with coronary heart disease, and 22 cases (16.67%) with malignant tumor. After admission, the patients were treated with antibiotics alone or in combination with antibiotics. Among them, 72 patients (54.55%) were treated with antibacterial drugs alone. The average length of hospital stay was (37.63±6.08) d;35 patients (26.52%) were antibacterials. On the basis of treatment, the average length of hospital stay (25.83±5.57) d was performed by CT or ultrasound guided percutaneous drainage. The antibacterial therapy was based on surgical treatment of 25 cases (18.94%), and the average hospital stay (20.44±4.39) d,the difference in hospitalization time between the three groups was statistically significant (F=27.8, P<0.05). Conclusion PLA is highly prevalent in older patients. The pathogens are mainly Klebsiella pneumoniae and Escherichia coli. The combination of antibacterial drugs and puncture drainage can shorten the hospitalization time and the curative effect is better.
作者
赵子昂
程君
叶英
李家斌
许夕海
ZHAO Zi-ang;CHENG Jun;YE Ying;LI Jia-bin;XU Xi-hai(Department of Infectious Diseases,the First Affiliated Hospital of Anhui Medical University, Hefei 230022,Anhui,China)
出处
《医学信息》
2019年第10期124-125,128,共3页
Journal of Medical Information
基金
国家自然科学基金资助项目(编号:81673242)
关键词
细菌性肝脓肿
伴发症
病原体
Bacterial liver abscess
Associated disease
Pathogen
