2型糖尿病并细菌性肝脓肿48例临床特点及护理  

Clinical features of type II diabetes complicated with bacterial liver abscess in 48 patients and nursing care

作　　者：韩辉[1] 陈青[1] 孙秋英[1] 赵家军[1] 

机构地区：[1]山东大学附属省立医院,山东济南250021

出　　处：《齐鲁护理杂志》2010年第8期3-5,共3页Journal of Qilu Nursing

摘　　要：目的:总结2型糖尿病并细菌性肝脓肿的临床特点和护理方法。方法:对我院内分泌科收治的48例2型糖尿病并细菌性肝脓肿患者的症状、体征、实验室检查、影像学检查、治疗转归及护理资料进行回顾性分析。结果:48例患者均有发热、畏寒,仅11例有上腹痛,15例有肝区叩击痛,多数患者血白细胞总数和中性粒细胞比例明显升高,白蛋白明显降低,影像学检查示肝右叶、单发脓肿多见,细菌培养以肺炎克雷白杆菌为主。46例好转,1例自动出院,1例死亡。结论:2型糖尿病并细菌性肝脓肿病情重,临床表现不典型。早期诊断,及时穿刺引流,配合强效抗生素,积极控制血糖,加强支持治疗有利于控制病情、改善预后。术前积极调整机体状态,稳定血糖,做好心理护理;术中严密监护,积极配合穿刺引流,及时送检标本;术后加强饮食管理,24h内限制活动,密切观察引流液及监测血糖。做好出院指导,对带管出院患者的引流安全提供保障。Objective：To summarize the clinical features of type II diabetes complicated with bacterial liver abscess and nursing methods.Methods：The symptoms,signs,laboratory tests,imaging studies,treatment outcome and nursing data of 48 patients with type II diabetes complicated with bacterial liver abscess were analyzed retrospectively.All the patients were admitted to the endocrinology department of our hospital.Results：48 patients had fever and chills,only 11 patients had abdominal pain,15 patients had liver percussion pain;white blood cell count and neutrophil cells proportion increased while albumin decreased in most patients.Imaging examination showed that single abscess and abscess at the right lobe was more common.Klebsiella pneumoniae dominated in bacteria culture.46 patients improved,one was discharged from hospital with his will and one patient died.Conclusion：The conditions of the patients with type II diabetes complicated with bacterial liver abscess are severe and the clinical manifestation is not typical.Early diagnosis and timely percutaneous drainage,medication with powerful antibiotics,effective control of blood glucose and strengthening supportive treatment is conducive to controlling the disease and improving prognosis.The active adjustment of the body＇s condition of the patients,making good control of the level of blood sugar and careful psychological care should be done before surgery.The comprehensive inoperative and postoperative nursing care should also be provided for the patients very well,such as active cooperation in percutaneous drainage,timely sending samples,diet management and guidance on the discharged patient for protecting their security with drainage tube.

关 键 词：糖尿病 细菌性肝脓肿 临床特点 护理 

分 类 号：R473.5[医药卫生—护理学]