摘要
近年来,肺炎克雷伯菌导致肝脓肿(KPLA)和内源性眼内炎(EE)发病率明显上升,多见于老年人。糖尿病、胆道疾病、肺炎克雷伯菌感染均为KPLA并发EE的危险因素。多数患者先出现KPLA,病情明显好转后突然出现EE,少数患者KPLA与EE几乎同时发病,甚至先出现EE,后出现KPLA。早诊断是早治疗的前提,须应用敏感抗生素、控制血糖、营养支持等全身系统治疗,同时需实施肝脓肿置管引流、玻璃体腔内注射抗菌药物等针对性治疗,治疗不及时或疗效不佳,可致盲或需摘除眼球。综述了KPLA并发EE的发病原因、危险因素、诊断与治疗进展,建议糖尿病、肝胆疾病和眼病共管以降低眼球致残率。
In recent years,the incidence of liver abscess(KPLA)and endogenous endophthalmitis(EE)caused by Klebsiella pneumoniae has increased significantly,which is more common in the elderly.Diabetes,biliary tract disease,and Klebsiella pneumoniae infection were all risk factors for KPLA complicated with EE.Most patients had KPLA first,and EE suddenly appeared after the condition improved significantly.A few patients had KPLA and EE almost at the same time,and even EE first appeared,and then KPLA appeared.Early diagnosis is the premise of early treatment.It is necessary to apply sensitive antibiotics,control blood glucose,nutritional support and other systemic treatments.At the same time,targeted treatments such as catheter drainage of liver abscess and intravitreal injection of antibiotics are needed.If the treatment is not timely or the curative effect is not good,it can cause blindness or need to remove the eyeball.This article reviews the etiology,risk factors,diagnosis and treatment of KPLA complicated with EE,and suggests that diabetes,hepatobiliary diseases and eye diseases should be managed together to reduce the rate of ocular disability.
作者
刘凌云
贾志芳
蒋童新
郭伟林
李艳艳
尚培中
LIU Ling-yun;JIA Zhi-fang;JIANG Tong-xin;GUO Wei-lin;LI Yan-yan;SHANG Pei-zhong(Integrated Department,Huailai Shiji Hospital,Huailai,Hebei 075400,China;Department of General Surgery,The 81 st Group Army Hospital of the PLA,Zhangjiakou,Hebei 075000,China;Department of General Surgery,Huailai Shiji Hospital,Huailai,Hebei 075400,China)
出处
《河北北方学院学报(自然科学版)》
2025年第12期57-61,共5页
Journal of Hebei North University(Natural Science Edition)
基金
张家口市大健康和生物医疗专项重点研发计划项目(No.1921122D)。
关键词
肝脓肿
内源性眼内炎
糖尿病
肺炎克雷伯菌
Liver abscess
Endogenous endophthalmitis
Diabetes
Klebsiella pneumoniae
