合并不同基础疾病的细菌性肝脓肿患者临床特征分析  

Clinical feature of patients with pyogenic liver abscess with different underlying diseases

作　　者：张威[1] 陈国林[1] 王航 余良 孔祥璐 Zhang Wei;Chen Guolin;Wang Hang(Department of Infectious Diseases,First Affiliated Hospital,Harbin Medical University,Harbin 150000,Heilongjiang Province,China)

机构地区：[1]哈尔滨医科大学附属第一医院感染病科,哈尔滨市150000 [2]哈尔滨医科大学附属第二医院胆胰外科,哈尔滨市150000 [3]香港大学玛丽医院病理科,中国香港 [4]齐齐哈尔市第一医院耳鼻喉头颈外科

出　　处：《实用肝脏病杂志》2023年第3期424-427,共4页Journal of Practical Hepatology

摘　　要：目的 分析并比较合并不同基础疾病的细菌性肝脓肿(PLA)患者的临床特征。方法 自2007年1月~2020年12月我院诊治的成年PLA患者,分析临床特征和结局。结果 在1930例PLA患者中,无糖尿病或胆道相关疾病者(A组)926例,有糖尿病者(B组)592例,有胆道疾病者(C组)261例和同时患有这两种疾病者(D组)151例;D组中性粒细胞百分比为(83.6±9.3)%,显著高于其他三组(P<0.05),B组和D组血清白蛋白水平分别为30.3(26.1,35.1)g/L和30.8(26.9,34.1)g/L,显著低于A组【32.3(28.3,36.8)g/L,P<0.05】;C组黄疸占比为11.9%,显著高于A组的5.5%和B组的2.7%(P<0.05),D组肺部病变占比为39.1%,显著高于A组的28.3%(P<0.05),B组和D组产气脓肿占比分别为15.4%和12.6%,显著高于A组的6.6%(P<0.05),D组脓肿直径为68.0(50.0,87.0)mm,显著大于其他三组(P<0.05);B组、C组和D组医疗花费分别为2.2(1.5,3.3)万元、2.3(1.5,3.4)万元和2.4(1.5,4.2)万元,显著高于A组【1.9(1.2,2.9)万元,P<0.05】。结论 合并基础疾病的PLA患者感染和消耗更重,住院花费相对较高,其中合并糖尿病患者可能需要更多次的穿刺引流治疗。Objective The purpose of this study was to analyze the clinical features of patients with pyogenic liver abscess(PLA)with different underlying diseases.Methods The adult PLA patients were encountered in our hospital between January 2007 and December 2020,and the clinical materials were collected and analyzed.Results Out of the 1930 patients with PLA in our series,926 patients(group A)had no underlying diseases,592 patients(group B)had type two diabetes mellitus(T2DM),261 patients(group C)had biliary diseases,and 151 patients(group D)had T2DM and biliary diseases;the percentage of neutrophils in group D was(83.6±9.3)%,much higher than in other three groups(P<0.05),serum albumin levels in group B and group D were 30.3(26.1,35.1)g/L and 30.8(26.9,34.1)g/L,much lower than[32.3(28.3,36.8)g/L,P<0.05]in group A;the incidence of jaundice in group C was 11.9%,significantly higher than 5.5%in group A and 2.7%in group B(P<0.05),the incidence of pulmonary lesions in group D was 39.1%,significantly higher than 28.3%(P<0.05)in group A,the proportions of aerogenic abscess in group B and group D were 15.4%and 12.6%,significantly higher than 6.6%(P<0.05)in group A,and the diameter of hepatic abscess in group D was 68.0(50.0,87.0)mm,significantly higher than in other three groups(P<0.05);the medical costs in group B,group C and group D were 20000.2(10000.5,30000.3)yuan,20000.3(10000.5,30000.4)yuan and 20000.4(10000.5,40000.2)yuan,significantly higher than[10000.9(10000.2,20000.9)yuan(P<0.05)]in group A.Conclusion The PLA patients with underlying diseases might have a severe disease,and have a relatively high hospitalization costs.

关 键 词：细菌性肝脓肿 糖尿病 胆道疾病 治疗 

分 类 号：R575.4[医药卫生—消化系统]