77例细菌性肝脓肿的临床诊治分析  

An analysis of clinical diagnosis and treatment of pyogenic liver abscess

作　　者：路亮[1] 张立翱[1] 郑可佳[1] 姚矾[1] 

机构地区：[1]巢湖市第一人民医院消化内科,238000

出　　处：《安徽医学》2010年第2期147-149,共3页Anhui Medical Journal

摘　　要：目的总结探讨细菌性肝脓肿(PLA)的病因、临床表现、病原菌及相应的治疗方法。方法回顾性分析77例PLA患者的临床资料,比较抗生素组、经皮穿刺引流组、外科治疗组的临床疗效。结果肝脓肿多见于青年和中年人,肝右叶多见,其症状以发热伴右上腹痛最多见,细菌来源最常见为隐源性(53.25%),其次为胆源性(27.27%)和肺源性(7.79%),最常见的病原菌依次为金黄色葡萄球菌(16.13%),肺炎克雷伯杆菌(9.68%),普通变形杆菌(6.45%),大肠杆菌(3.23%),经皮穿刺引流组的疗效与外科治疗组相似,并发症较少。结论PLA的症状以发热伴右上腹痛最多见,隐源性感染最多见,主要致病菌为金黄色葡萄球菌、肺炎克雷伯杆菌等。超声引导下经皮肝脓肿穿刺安全有效,可作为直径5～10 cm肝脓肿首选的诊治方法。Objective To analyse and summarize the etiology,clinical feature,pathogenic bacteria and treatment methods of pyogenic liver abscess（PLA）.Methods The clinical data of 77 cases with PLA were retrospectively studied,and the treatment result among consertive,aspiration and surgical groups were compared.Results PLA were frequently developed in the right lobe,especially in younger and middle-aged men.The common clinical manifestations were fever and abdominal pain in the right upper quadrant.The common cause of PLA were cryptogenic（53.25%）,biliary tract diseases（27.27%）and pneumonia（7.79%）.S.aureus（16.13%）,Klebsiella pneumoniae（9.68 %）,Proteus vulgaris（6.45%）and E.coli（3.23%）were the most common pyogenic pathogen.The effective of percutaneous aspiration and operation aspiration was similarly.The complication of percutaneous aspiration is fewer than operation aspiration.Conclusion The most common clinical feature of PLA was fever and abdominal pain in the right upper quadrant.Cryptogenic is the most common.The most common pyogenic pathogen were S.aureus,Klebsiella pneumoniae and so on.Percutaneous aspiration is safe and effect,it would become the first treatment method in PLA that the diameter is 5 to 10 cm.

关 键 词：细菌性肝脓肿 诊断 治疗 

分 类 号：R575.4[医药卫生—消化系统]