中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
5期
367-369
,共3页
裴铁民%韩志阳%吕克言%麻勇%尹大龙%刘连新
裴鐵民%韓誌暘%呂剋言%痳勇%尹大龍%劉連新
배철민%한지양%려극언%마용%윤대룡%류련신
肝脓肿%抗菌药%克雷伯菌,肺炎%厄他培南
肝膿腫%抗菌藥%剋雷伯菌,肺炎%阨他培南
간농종%항균약%극뢰백균,폐염%액타배남
Liver abscess%Anti-bacterial agents%Klebsiella pneumoniae%Ertapenem
目的 探讨厄他培南对细菌性肝脓肿的治疗效果.方法 回顾分析2009年3月至2011年3月期间应用厄他培南治疗的细菌性肝脓肿患者134例,评价其临床有效性和细菌学疗效.结果 本组患者的临床表现包括发热122例(91％),腹部疼痛70例(52.2％),寒战66例(49.3％).92例脓肿(68.7％)位于肝右叶.外周血白细胞升高者73例(54.8％),肝功能异常者84例(62.7％).B超诊断率为76.6％.本组患者单纯应用厄他培南治疗41例(30.6％),厄他培南+经皮肝穿刺抽脓82例(61.2％),厄他培南+外科手术11例(8.2％),其临床有效率分别为89％,87.8％,90.9％.患者平均用药时间为(7.0±2.4)d,平均住院时间为14.2d.共培养出97株致病菌,主要致病菌为肺炎克雷伯菌,细菌清除率为92.8％.检出的细菌中对厄他培南敏感性为94.8％.结论 厄他培南可作为经验性治疗细菌性肝脓肿首选药物.
目的 探討阨他培南對細菌性肝膿腫的治療效果.方法 迴顧分析2009年3月至2011年3月期間應用阨他培南治療的細菌性肝膿腫患者134例,評價其臨床有效性和細菌學療效.結果 本組患者的臨床錶現包括髮熱122例(91％),腹部疼痛70例(52.2％),寒戰66例(49.3％).92例膿腫(68.7％)位于肝右葉.外週血白細胞升高者73例(54.8％),肝功能異常者84例(62.7％).B超診斷率為76.6％.本組患者單純應用阨他培南治療41例(30.6％),阨他培南+經皮肝穿刺抽膿82例(61.2％),阨他培南+外科手術11例(8.2％),其臨床有效率分彆為89％,87.8％,90.9％.患者平均用藥時間為(7.0±2.4)d,平均住院時間為14.2d.共培養齣97株緻病菌,主要緻病菌為肺炎剋雷伯菌,細菌清除率為92.8％.檢齣的細菌中對阨他培南敏感性為94.8％.結論 阨他培南可作為經驗性治療細菌性肝膿腫首選藥物.
목적 탐토액타배남대세균성간농종적치료효과.방법 회고분석2009년3월지2011년3월기간응용액타배남치료적세균성간농종환자134례,평개기림상유효성화세균학료효.결과 본조환자적림상표현포괄발열122례(91％),복부동통70례(52.2％),한전66례(49.3％).92례농종(68.7％)위우간우협.외주혈백세포승고자73례(54.8％),간공능이상자84례(62.7％).B초진단솔위76.6％.본조환자단순응용액타배남치료41례(30.6％),액타배남+경피간천자추농82례(61.2％),액타배남+외과수술11례(8.2％),기림상유효솔분별위89％,87.8％,90.9％.환자평균용약시간위(7.0±2.4)d,평균주원시간위14.2d.공배양출97주치병균,주요치병균위폐염극뢰백균,세균청제솔위92.8％.검출적세균중대액타배남민감성위94.8％.결론 액타배남가작위경험성치료세균성간농종수선약물.
Objective To explore the efficacy of an antibiotic ertapenem for the treatment of bacterial liver abscess. Method The clinical data of 134 hospitalized bacterial liver abscess patients were retrospectively analyzed to evaluate the clinical and bacteriological efficacy of ertapenem from March 2009-2011in our hospital. Result Fever was present in 122 (91％)cases,abdominal pain was complained in 70 (52.2％ ) cases and rigor in 66 (49.3％ ) cases.In 92(68.7％ ) cases the abscess was located in the right lobe of the liver.Leukocytosis and liver dysfunction were found in 73 cases(54.8％ ) and 84 cases (62.7％ ),respectively.Ultrasonography was the most effective diagnostic means for liver abscess.Fortyone cases(30.6％ )were treated conservatively with ertapenem and 82(61.2％ )were treated with ertapenem associated with percutaneous liver puncture aspiration and 11cases (8.2％ )were treated with ertapenem associated with surgery.The clinical success rate was respectively 89％,87.8％,90.9％.The average duration of medication and length of stay were respectively ( 7.0 ± 2.4 ) d and 14.2 d.Ninety-seven pathogens were isolated from samples and predominant strains were Klebsiella species.Bacterial eradication rate was 92.8％.The sensitivities of isolated bacteria to ertapenem were 94.8％.Conclusions Ertapenem administration is effective therapy for bacterial liver abscess.
