细菌性肝脓肿64例诊治分析  

Diagnosis and treatment of pyogenic liver abscesses: a report of 64 cases

作　　者：蔡岷[1] 何彦安[1] 丁辉[1] 蔡宇[1] 何永红[1] 陈庆[1] 

机构地区：[1]江油市人民医院普通外科,四川江油621700

出　　处：《川北医学院学报》2015年第5期673-676,共4页Journal of North Sichuan Medical College

摘　　要：目的:总结本地区细菌性肝脓肿的临床特征、病因分类及诊治经验。方法:回顾性分析2008年9月至2013年8月间收治的细菌性肝脓肿64例患者的一般情况、临床特征、实验室和影像学结果、诊治经过和临床转归。结果:全组有24例细菌性肝脓肿(<3 cm)行单纯内科保守治疗,30例行超声介导下肝脓肿穿刺抽脓或引流,15例行开腹/腹腔镜下肝脓肿切开引流,其中有5例行脓肿穿刺置管引流后疗效不佳而再行剖腹手术治疗。2例患者(3.13%)死亡。结论:本地区细菌性肝脓肿以胆源性为主,常合并有肝胆管结石等胆道疾患,影像学上常表现为多发的小脓肿,致病菌常为多重耐药,治疗上常因超声介导下穿刺引流效果不佳而需剖腹/腹腔镜下手术。Objective： To summarize the clinical symptom,cause categories and treatment of pyogenic liver abscesses（ PLA）in our district. Methods： The clinical data of 64 patients with PLA who were treated in our hospital from September 2008 to August2013 were retrospectively analyzed to determine the demographic,clinical features,laboratory and imaging findings,the management strategy as well as the treatment outcome of patient. Results： There were 24 patients with the abscess diameter 〈3 cm underwent the simple conservative medical treatment,30 patients underwent the puncture aspiration of pus and drainage tube by the ultrasound guiding,15 patients recovered with the help of the operative drainage and 5 among them had poor therapeutic effect after the puncture aspiration of pus and drainage tube by the ultrasound guiding. Two patients（ 3. 13%） died due to MODS. Conclusion： In our district the majority of PLA was associated with biliary tract and usually combined with kinds of biliary diseases such as hepatolithiasis. It often shows multiple small abscesses in imaging and multiple drug resistant bacteria infection. For the patients,if the effect of ultrasound guided puncture and drainage is not good enough,laparotomy or laparoscopic surgery is needed.

关 键 词：肝脓肿 回顾性分析 诊断 治疗 

分 类 号：R657.33[医药卫生—外科学]