双重细菌性肝脓肿7例病原学和临床特点  

Pathogenic and clinical characteristics of 7 cases of double bacterial hepatic abscess

作　　者：李智德 宋巍[1] 马志刚[1] 李玉鹏 田广磊[1] 马超[1] 陈雄[1] LI Zhide;SONG Wei;MA Zhigang;LI Yupeng;TIAN Guanglei;MA Chao;CHEN Xiong(Department of Hepatobiliary Surgery,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院肝胆外科,新疆乌鲁木齐830001

出　　处：《现代医药卫生》2024年第1期35-38,共4页Journal of Modern Medicine & Health

基　　金：新疆维吾尔自治区区域协同创新专项(上海合作组织科技伙伴计划及国际科技合作计划,ZYYD2023C09);新疆维吾尔自治区创新环境(人才、基地)建设专项(人才专项计划-天山创新团队,2021D14005);新疆维吾尔自治区人民医院院内项目(20220201,20200214)。

摘　　要：目的 探讨7例双重细菌性肝脓肿患者的病原学特点及临床特点。方法 回顾性分析该院2015年1月至2021年10月收治的7例双重细菌性肝脓肿患者的临床资料,分析细菌谱及临床表现、并发症等,总结双重细菌性肝脓肿的临床特点。结果 7例双重细菌性肝脓肿患者年龄22.0~78.0岁,平均(58.9±17.7)岁,平均住院时间(15.6±10.9)d,6例(85.7%)合并基础疾病及既往有手术史,发热(71.4%)、腹痛(57.1%)为主要症状,肺炎和胸腔积液为主要并发症。脓肿平均直径为(6.1±3.2)cm,所有患者均行经皮经肝脓肿穿刺引流术联合抗生素抗感染而治愈。所有患者均出现不同程度肝功能损伤。主要致病菌为肺炎克雷伯杆菌和大肠埃希菌,头孢类、喹诺酮类抗生素耐药比例均为57.1%(4/7),碳青霉烯类抗生素耐药比例为28.6%(2/7)。结论 双重肝脓肿好发于合并基础疾病及腹部手术史的老年人,肺炎克雷伯杆菌和大肠埃希菌为主要致病菌,且易耐药。Objective To explore the pathogenic and clinical characteristics of 7 cases of double bacterial hepatic abscess.Methods The clinical data of 7 cases of double bacterial hepatic abscess treated in this hospital from January 2015 to December 2021 were analyzed retrospectively.The bacterial spectrum,clinical manifestations and complications were analyzed,and the clinical characteristics of double mixed bacterial hepatic abscess were summarized.Results In 7 cases of double mixed bacterial hepatic abscess,the age was 22.0-78.0 years old,the mean age was(58.9±17.7) years old,the mean hospital stay time was(15.6±10.9) d.Six cases(85.7%) were complicated with underlying disease and previous surgical history.Fever(71.4%) and abdominal pain(57.1%) were the main symptoms.Pneumonia and pleural effusion were the main complications.The mean diameter of hepatic abscess was(6.1±3.2)cm,and all patients were cured by percutaneous puncture and drainage of hepatic abscess combined with antibiotics for anti-infection treatment.All patients had varied degree of liver function injury.The main pathogenic bacteria were Klebsiella pneumoniae and Escherichia coli.The proportions of cephalosporin and quinolone antibiotic resistance all were 57.1%(4/7),and carbopenem antibiotic resistance proportion was 28.6%(2/7).Conclusion Double mixed hepatic abscess usually occurs in the elderly patients with complicating underlying disease and previous surgical history.Klebsiella pneumoniae and Escherichia coli are main pathogenic bacteria,moreover which are easy to have drug resistance.

关 键 词：细菌性肝脓肿 病原学 临床特点 

分 类 号：R575.4[医药卫生—消化系统]