上海金山地区30例细菌性肝脓肿回顾分析  

Retrospective analysis of 30 cases bacterial liver abscess in Jinshan district of Shanghai

作　　者：李欢庆[1] 卜淑蕊[1] 

机构地区：[1]复旦大学附属金山医院消化科,上海200540

出　　处：《临床内科杂志》2012年第9期618-620,共3页Journal of Clinical Internal Medicine

摘　　要：目的研究近5年上海金山地区细菌性肝脓肿病因与伴发疾病之间的关系，了解该地区血吸虫肝病伴发肝脓肿的临床特点及诊治经验，分析其易患因素和预防策略。方法回顾性分析30例细菌性肝脓肿患者的临床资料、影像学特点、治疗及既往是否有胆囊切除术史等，并对其中并发血吸虫肝病与未合并血吸虫肝病患者的临床资料进行比较。结果30例患者中，10例合并血吸虫肝病的肝脓肿患者症状不典型，仅以中等发热、腹胀及纳差为主要临床表现；而20例未合并血吸虫肝病患者以高热、寒战、右上腹胀痛、肝肿大及白细胞计数升高，伴有或不伴转氨酶升高为主要临床表现。B超和CT检查首诊阳性率均为96．7％（29／30），疑诊率为3．3％（1／30）。结论上海金山地区血吸虫肝病伴发肝脓肿的患者临床特点多不典型，早期诊断和恰当治疗是关键；血吸虫肝病并发糖尿病及有胆曩手术史患者比在相同基础病的非血吸虫肝病患者中伴发肝脓肿的比例高。Objective To study the association of Liver schistosomiasis comorbid with pyogenic hepatic abscess, summarize our experience on its diagnosis and treatment within recent 5 years in Jinshan distict of Shanghai, and to explore the predispose factors and preventive management. Methods 30 patients with pyogenic liver abscess were analyzed by clinical data, radiological characteristics, the efficacy and history of cholecystectomy clinic date were compared between pyogenic liver abscess with and without schistosomiasis. Result Of 30 patients, the presenting symptoms of l0 cases with liver schistosomiasis were atypical,including moderate fever, abdominal distension and anorexia, other 20 cases without liver schistosomiasis manifested with high fever, chills and abdominal pain of right-upper-quadrant, hepatomegaly and leukocytosis, with or without elevated liver function. The diagnostic sensitivities of ultrasonography （US） and computed tomography （CT） were 96.7% , suspected rate was 3.3%. Conclusions The symptoms of liver schistosomiasis comorbid with pyogenic hepatic abscess in Jin shan distict of Shanghai are atypical, earlier diagnosis and proper therapy are key issue, the incidence rate of liver schistosomiasis comorbid with hepatatic abscess is higher in Liver schistosomiasis comlicated with diabetes or eholecystectomy history than those withoutliver schistosomiasis.

关 键 词：血吸虫性肝病 细菌性肝脓肿 诊断 治疗 

分 类 号：R575.4[医药卫生—消化系统]