隐源性细菌性肝脓肿临床特点分析

发布时间：2018-06-08 07:07

本文选题：肝脓肿 + 隐源性　；参考：《中国实用外科杂志》2017年02期

【摘要】：目的探讨隐源性细菌性肝脓肿的临床特点,为临床决策提供相关依据。方法回顾性分析2013年1月至2016年6月间浙江大学医学院附属第二医院肝胆胰外科连续收治的86例细菌性肝脓肿病人的临床资料。根据病因分为隐源性组(51例)和非隐源性组(35例)。比较两组临床表现、实验室及病原学检查结果、治疗及预后情况。结果隐源性组年龄、伴发胆管结石和恶性肿瘤比例低于非隐源性组,而男性病人和糖尿病病人比例高于非隐源性组(P0.05);隐源性组出现血小板降低和总胆红素升高的比例低于非隐源性组(P0.05);最常见病原菌为肺炎克雷伯菌,但隐源性组肺炎克雷伯菌的检出率明显高于非隐源性组(P0.05),而大肠埃希菌的检出率低于非隐源性组(P0.05);两组治疗均以抗生素联合穿刺引流为主,但隐源性组住院时间较短,预后不良事件的发生率较低(P0.05)。结论隐源性细菌性肝脓肿好发于中老年男性糖尿病病人,主要病原菌为肺炎克雷伯菌,以控血糖、抗感染、积极穿刺引流为治疗原则,预后较好。
[Abstract]:Objective to investigate the clinical features of cryptogenic bacterial liver abscess and to provide relevant evidence for clinical decision-making. Methods the clinical data of 86 patients with bacterial liver abscess were retrospectively analyzed from January 2013 to June 2016 in the second affiliated Hospital of Zhejiang University Medical College. According to the etiology, there were 51 cases of cryptogenic group (n = 51) and 35 cases of non-cryptogenic group (n = 35). The clinical manifestations, laboratory and etiological findings, treatment and prognosis were compared between the two groups. Results the age, the proportion of cholelithiasis and malignant tumor in the cryptogenic group were lower than those in the non-cryptogenic group. However, the proportion of male and diabetic patients was higher than that of non-cryptogenic group (P 0.05); the proportion of patients with thrombocytopenia and total bilirubin in cryptogenic group was lower than that of non-cryptogenic group (P 0.05); the most common pathogen was Klebsiella pneumoniae, the most common pathogen was Klebsiella pneumoniae. However, the detection rate of Klebsiella pneumoniae in the cryptogenic group was significantly higher than that in the non-cryptogenic group, while the detection rate of Escherichia coli was lower than that in the non-cryptogenic group. The incidence of adverse events of prognosis was lower than that of P0.05. Conclusion Cryptogenic bacterial liver abscess is common in middle-aged and aged male diabetic patients. The main pathogen is Klebsiella pneumoniae. The main pathogenic bacteria is Klebsiella pneumoniae. The treatment principle is blood glucose control, anti-infection and positive puncture and drainage, and the prognosis is good.
【作者单位】：浙江大学医学院附属第二医院肝胆胰外科;
【基金】：国家自然科学基金(No.81472212) 浙江省医药卫生科技省部共建项目(No.WKJ-ZJ-1410) 浙江省中医药科技计划重点项目(No.2014ZZ007)
【分类号】：R575.4

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