310例细菌性肝脓肿临床治疗分析  

Clinical analysis and experience of 310 cases of bacterial liver abscess

作　　者：邬文博 李玉鹏 陈雄[1] 马志刚[1] 陈伦牮[1] WU Wenbo;LI Yupeng;CHEN Xiong;MA Zhigang;CHEN Lunjian(Hepatobiliary and Pancreatic Center,The People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,830001,China;Graduate School,Xinjiang Medical University,Urumqi,830054,China)

机构地区：[1]新疆维吾尔自治区人民医院肝胆胰中心,乌鲁木齐830001 [2]新疆医科大学研究生学院,乌鲁木齐830054

出　　处：《新疆医学》2025年第1期33-36,40,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区科技支疆项目(项目编号:ZYYD2023C09)。

摘　　要：目的 通过回顾性分析310例细菌性肝脓肿资料,探讨肺炎克雷伯杆菌性肝脓肿与大肠埃希菌性肝脓肿的异同。方法 回顾性收集2007年1月至2021年12月诊断为细菌性肝脓肿临床资料,分析其临床特征、治疗方式,将肺炎克雷伯杆菌肝脓肿与大肠埃希菌肝脓肿作为亚组进行比较分析。结果 发现患有肺炎克雷伯杆菌感染的人群中存在较高比例的糖尿病病例,同时5至10厘米直径内的孤立性肝脓肿病例数量较为常见。此外,采用抗生素与经皮肝穿刺胆道引流术(Percutaneous transhepatic cholangial drainage,PTCD)相结合的治疗方式在临床运用比率亦较高。在并发症方面,脓毒血症的发生比例显著增加。肺炎克雷伯杆菌引发的肝脓肿与糖尿病和腹部手术史有关,而大肠埃希菌感染则与性别差异、胆道肿瘤、其他并发病状以及肝脏疾病有一定的关联。结论 细菌性肝脓肿是常见性肝脏感染性疾病,早期诊断并获得细菌学培养结果在临床治疗中具有重要意义,早期的经皮肝脓肿穿刺引流联合敏感抗生素使用是有效治疗方式。ObjectiveTo investigate the similarities and differences between Klebsiella pneumoniae liver abscess and Escherichia coli liver abscess by retrospectively analyzing the data of 310 cases of bacterial liver abscess.MethodsClinical data of 310 patients diagnosed with bacterial liver abscess from January 2007 to December 2021 were retrospectively collected,and their clinical characteristics,treatment modalities were analyzed,and the differences and similarities between Klebsiella pneumoniae liver abscess(KPLA)and Escherichia coli liver abscess(E.coli liver abscess,ECLA)were investigated as a subgroup,and were analyzed for comparison.Results A higher proportion of diabetes cases were found in people with Klebsiella pneumoniae infection,while the number of isolated liver abscess cases within diameter of 5 to 10 cm was more common.In addition,a combination of antibiotics and percutaneous transhepatic cholangial drainage(PTCD)was also used at a high clinical application rate.In terms of complications,there was a significant increase in the incidence of sepsis.Liver abscesses caused by Klebsiella pneumoniae were associated with diabetes mellitus and a history of abdominal surgery,whereas Escherichia coli infections were associated with gender differences,biliary tract tumors,other co-morbid symptoms,and liver disease.ConclusionBacterial liver abscess is a common infectious disease of the liver,early diagnosis and bacteriologic culture results are important in clinical management,and early percutaneous drainage of liver abscesses combined with the use of sensitive antibiotics is an effective treatment modality.

关 键 词：细菌性肝脓肿 肺炎克雷伯 大肠埃希菌 临床特征 

分 类 号：R615[医药卫生—外科学]