柴胡清肝汤联合西医治疗合并糖尿病的细菌性肝脓肿疗效观察

发布时间：2019-02-16 12:44

【摘要】：目的:总结合并糖尿病的细菌性肝脓肿临床特点,并研究柴胡清肝汤联合西医治疗该病的疗效。方法:回顾性分析2011年4月至2015年6月蓟县人民医院收治的40例合并糖尿病的细菌性肝脓肿患者(其中20例应用柴胡清肝汤联合西医治疗,另外20例应用单纯西医方法治疗)的病因、临床表现、实验室检查、影像学检查、治疗方法及预后等资料。结果:1.所有患者中男26例,女14例,年龄30~80岁,平均(59.28±11.78)岁。所有患者均有发热,热型不规则,体温高峰38.2~41.0℃,伴恶心、呕吐者18例,纳差、食欲减退者28例,自觉肝区疼痛者26例,肝区有叩击痛者33例。入院后化验血糖平均(14.95±5.65)mmol/L,糖化血红蛋白(9.12±2.44)%。所有患者均进行了细菌培养(血液和/或脓液),其中血培养24例,其中6例阳性,分别为肺炎克雷伯菌4例,大肠埃希菌2例,脓液培养16例,其中阳性5例,分别为3例肺炎克雷伯杆菌,1例大肠杆菌,1例金黄色葡萄球菌。影像学检查提示肝右叶脓肿24例、左叶脓肿7例,两叶均有9例;其中脓肿单发者27例,多发13例,脓腔大小范围为2.0cm×1.8cm~11.8cm×8.8cm。2.柴胡清肝汤联合西医治疗该病有效率95%,平均住院时间13.30±3.36天,西医治疗组有效率85%,平均住院时间(18.45±5.23)天。结论:1.合并糖尿病的细菌性肝脓肿患者以老年人多见;隐匿性感染比例高;临床表现不典型;大多血糖控制不良、营养状况差;细菌培养阳性率低,肺炎克雷伯杆菌多见;脓肿多为单发,以右叶多见。2.柴胡清肝汤联合西医治疗合并糖尿病的细菌性肝脓肿疗效显著。
[Abstract]:Objective: to summarize the clinical features of bacterial liver abscess complicated with diabetes and to study the curative effect of Chaihu Qinggan decoction combined with western medicine. Methods: from April 2011 to June 2015, 40 patients with bacterial liver abscess complicated with diabetes mellitus were analyzed retrospectively. Among them, 20 cases were treated with Chaihu Qinggan decoction combined with western medicine. The etiology, clinical manifestation, laboratory examination, imaging examination, treatment method and prognosis of 20 cases. Results: 1. There were 26 males and 14 females, aged 30 to 80 years (mean (59.28 卤11.78) years old). All patients had fever, irregular heat type, temperature peak of 38.2 鈩，

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