2型糖尿病与非糖尿病合并细菌性肝脓肿的临床分析

发布时间：2018-12-18 05:19

【摘要】：目的：探讨2型糖尿病与非糖尿病患者合并细菌性肝脓肿临床特点差异，为其诊断、治疗提供依据。方法：回顾分析细菌性肝脓肿患者75例临床资料，其中2型糖尿病并发细菌性肝脓肿28例（DM组），非糖尿病细菌性肝脓肿47例（非DM组），比较两组一般资料、临床表现、辅助检查、肝脓肿特点、治疗方法及疗效等。结果：两组年龄及性别差异无统计学意义(P0.05)，两组上腹痛症状、腹部压痛体征差异有统计学意义(P0.05)；实验室检查两组比较白细胞计数、总胆红素、直接胆红素、间接胆红素升高及血小板计数300×109/L例数差异有统计学意义(P0.05)；脓液细菌培养阳性率及肺炎克雷伯杆菌培养率两组比较差异有显著性(P0.025)；两组抗菌药物使用时间差异有统计学意义(P0.05)。DM组患者延误诊治较非DM组多，差异有统计学意义(P0.05)。75例细菌性肝脓肿患者经过综合治疗后均好转出院。结论：糖尿病并发肝脓肿患者症状体征不明显，，容易漏诊误诊，且易并发其他部位感染，病原菌以肺炎克雷伯杆菌多见，治疗应强调有效控制血糖、及时穿刺治疗、合理、足量应用抗菌药物、脓腔个体化治疗和营养支持，从而提高疗效，降低住院费用。
[Abstract]:Objective: to explore the difference of clinical features between type 2 diabetes mellitus and non-diabetic patients with bacterial liver abscess. Methods: the clinical data of 75 patients with bacterial liver abscess were retrospectively analyzed, including 28 cases of type 2 diabetes complicated with bacterial liver abscess (DM group) and 47 cases of non-diabetic bacterial liver abscess (non-DM group). Auxiliary examination, characteristics of liver abscess, treatment method and curative effect etc. Results: there was no significant difference in age and sex between the two groups (P0.05). There were significant differences in symptoms and signs of abdominal tenderness between the two groups (P0.05). The white blood cell count, total bilirubin, direct bilirubin, indirect bilirubin and platelet count of 300 脳 109 / L were significantly different between the two groups (P0.05). The positive rate of bacterial culture in pus was significantly higher than that of Klebsiella pneumoniae (P0.025). There was significant difference between the two groups in the time of use of antibiotics (P0.05). 75 patients with bacterial liver abscess were discharged after comprehensive treatment. (P0.05) there was more delay in diagnosis and treatment in the). DM group than in the non-DM group (P0.05). Conclusion: the symptoms and signs of patients with diabetes mellitus complicated with liver abscess are not obvious, it is easy to miss diagnosis and misdiagnosis, and it is easy to be complicated with infection of other parts. Klebsiella pneumoniae is the most common pathogen. The treatment should emphasize the effective control of blood sugar, timely puncture treatment and reasonable treatment. Adequate use of antimicrobial agents, individualized treatment of pus cavity and nutritional support, so as to improve the efficacy and reduce hospital costs.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.1;R575.4

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