多重耐药菌性不典型肾周脓肿合并糖尿病的诊断和处理  

Diagnosis and treatment of multidrug-resistant organism of atypical perinephric abscess complicated by diabetes

作　　者：万旭辉[1] 赖建平[1] 李健[1] 付光华[1] 李兴斌[1] 甘道举[1] 文小平[1] 

机构地区：[1]宜宾市第一人民医院泌尿外科,四川宜宾644000

出　　处：《四川医学》2012年第8期1368-1370,共3页Sichuan Medical Journal

摘　　要：目的探讨多重耐药菌性不典型肾周脓肿合并糖尿病的诊断和处理方法。方法对18例多重耐药菌性不典型肾周脓肿合并糖尿病的患者资料作回顾性分析。结果术前2例误诊为急腹症,2例误诊为腰大肌结核性脓肿,4例误诊为腹膜后肿瘤,10例诊断为肾周脓肿,13例并发脓毒血症。所有患者脓液培养为多重耐药菌感染,行肾周脓肿切开引流术,术后血糖控制满意,18例治愈出院。结论多重耐药菌性肾周脓肿合并糖尿病的症状常不典型,易致误诊,控制血糖、尽早选用敏感抗菌素、早诊断及早期行肾周脓肿切开引流术是治疗成功的关键。Objective To explore the diagnosis and treatment of multidrug-resistant organism of atypical perinephric ab- scess complicated by diabetes. Methods We analyzed retrospectively the clinical data of 18 cases with multidrug-resistant organ- ism of atypical perinephric abscess complicated by diabetes. Results Preoperative 2 cases were misdiagnosed as acute abdomen, 2 cases were misdiagnosed as tuberculous psoas abscess, 4 cases were misdiagnosed as retroperitoneal tumor, 10 eases were diag- nosised perinephric abscess, 13 cases complicated by sepsis. All cases of pus were cultured to be the multi-drug resistant infec- tions, surgical incision and drainage of perinephric abscess was executed, satisfactory blood glucose was controlled after operation and 18 cases were cured. Conclusion Muhidrug-resistant organism of perinephric abscess complicated by diabetes has not typical symptoms,it easily lead to misdiagnosis. Good control of blood glucose, sensitive antibiotics used as soon as possible, early diagno- sis, early surgical incision and drainage of perinephric abscess are the key to successful treatment.

关 键 词：肾周脓肿 糖尿病 多重耐药菌 切开引流术. 

分 类 号：R692[医药卫生—泌尿科学] R587.1[医药卫生—外科学]