摘要
目的加强对肝脓肿的认识，为临床诊疗工作提供参考。方法回顾性分析102例肝脓肿病例，总结其临床特性和诊疗情况。结果患者临床表现中发热最为多见（94例，92．2％），其次为畏寒、寒战（49例，48．0％）、腹痛（44例，43．1％）等。外周血白细胞升高者占55．9％（57例）。胆系疾病（45例，44．1％）和糖尿病（41例，40．2％）是主要发病因素。胆道是主要感染途径．另有部分为隐源性，39例隐源性者中19例合并糖尿病。首选诊断方法为B超（诊断率70．6％）。但有7例（6．9％）患者通过B超、CT、MRI检查仍未获确诊，需行经皮肝穿刺或剖腹探查。56％（75例中42例）的患者细菌培养阴性。所获41株细菌中以肺炎克雷伯杆菌为主（63．4％）。亚胺培南、舒巴坦＋头孢哌酮、舒巴坦＋氨苄西林、阿米卡星、头孢他啶、头孢吡肟对革兰阴性菌较为敏感（敏感性〉90％）。万古霉素、替考拉宁对革兰阳性菌较为敏感（敏感性100％）。结论糖尿病患者易发肝脓肿。
Objective To further understand liver abscesses, so as to guide the clinical work. Methods The clinical data of 102 patients with liver abscesses were retrospectively analyzed. The clinical features of the patients and treatment were summarized. Results The patients usually presented with fever （n = 94, 92. 2%）, chill and rigor （n = 49, 48. 0%） and abdominal pain （n = 44, 43. 1%）. Among 102 patients,57（55.9%） had leukocytosis. Biliary tract diseases and diabetes mellitus were common underlying diseased found in 45 （44.1% ） and 41 （40.2%） patients with liver abscesses, respectively. The infection were more commonly found via biliary tract than via cryptogenic. Ultrasonography was the first choice for diagnosis of the liver abscessed （diagnostic rate 70. 6%）. But 7 （6. 9%） patients who failed diagnoses with ultrasonography , CT or MR image were performed ultrasonography guided percutaneous aspiration or surgical operation. Negative germicultures were identified in 56% （42/75）of patients. Forty-one strains were isolated and Klebsiella pneumoniae （63.4%） was the most predominat. The sensitivities of Gram negative bacilli to imipenem, sulperazon, unasyn, amikacin, ceftazidime, cefepime were 〉 90 %, while the sensitivities of Gram positive coccus to vancomycin and teicoplanin were 100%. Conclusion Patients with diabetes mellitus are susceptible to liver abscesses.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2008年第2期88-90,共3页
Chinese Journal of Digestion
关键词
肝脓肿
胆系疾病
糖尿病
Liver abscesses
Biliary tract diseases
Diabetes mellitus
