糖尿病并发细菌性肝脓肿的临床特点及诊治探讨  

The clinical features and cure methods of diabetes companied with pyogenic hepatic abscess

作　　者：赵欣[1] 王邦茂[2] 张继红[1] 崔立波[1] 刘雁冰[1] 

机构地区：[1]中国人民解放军第272医院内一科,天津300020 [2]天津医科大学总医院消化科

出　　处：《胃肠病学和肝病学杂志》2007年第4期384-387,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：湖南省自然科学基金(03GGY3060)

摘　　要：目的总结糖尿病并发细菌性肝脓肿(diabetes companied with pyogenic hepatic abscess,DPHA)的临床特点及诊治经验。方法回顾性调查自1997年至2006年天津医科大学总医院消化科收治的16例DPHA和同期收治的16例非糖尿病并发细菌性肝脓肿(NDPHA)患者的临床资料并进行对比分析。结果DPHA组症状不典刑者、合并胆系感染、合并胸腔积液或右下肺炎、出现贫血的比例、平均血ALP值和平均住院日都分别高于NDPHA组,而痊愈率低于NDPHA。上述指标两组间均具有有统计学差异(P<0.05)。DPHA组细菌培养阳性6例,均为肺炎克雷伯菌,NDPHA组培养阳性5例,包括3株肺炎克雷伯菌、1株埃希氏大肠杆菌和1株假单胞菌。结论糖尿病合并细菌性肝脓肿症状多不典型而病情更重,肺炎克雷伯菌感染多见。治疗宜及时采取个体化和综合措施,必要时应早期外科处理。Objectives To investigate the clinical features and therapy of diabetes companied with pyogenic hepatic abscess （DPHA）. Methods The clinical data of 16 cases of DPHA and 16 cases of nondiabetes companied with pyogenic hepatic abscess （NDPHA） in our hospital from 1997 to 2006 were analyzed in this retrospective study. Results The rates of atypical manifestations, complications such as biliary tract infections, pleural effusion or pneumonia, anemia, mean blood ALT values and hospitalization days in DPHA patients were higher than those in NDPHA patients respectively, while cure rates in DPHA patients were lower. There were significant differences in those data between two groups （ P - 0.05）. All of 6 pathogens isolated from DPHA patients were Klebsiella pneumoniae, and 5 pathogens isolated from NDPHA patients included 3 strains of Klebsiella pneumoniae, 1 strains of Eschedchia coli and I strains of Pseudomonas. Conclusions Atypical manifestations, severe state and Klebsiella pneumoniae infections were common in DPHA patients. DPHA should be treated with individual and comprehensive approaches in time. Earlier surgical processes should be taken if necessary.

关 键 词：糖尿病 细菌性肝脓肿 临床特点 诊断 治疗 

分 类 号：R575.4[医药卫生—消化系统]