传染病信息
傳染病信息
전염병신식
INFECTIOUS DISEASE INFORMATION
2014年
3期
157-159,166
,共4页
张成龙%郭晶晶%贾天野%崔恩博%陈素明%李勇武%张鞠玲%王欢%鲍春梅%庞君丽%曲芬%毛远丽
張成龍%郭晶晶%賈天野%崔恩博%陳素明%李勇武%張鞠玲%王歡%鮑春梅%龐君麗%麯芬%毛遠麗
장성룡%곽정정%가천야%최은박%진소명%리용무%장국령%왕환%포춘매%방군려%곡분%모원려
肝脓肿,化脓性%体征和症状%病原%肺炎克雷伯菌%治疗学
肝膿腫,化膿性%體徵和癥狀%病原%肺炎剋雷伯菌%治療學
간농종,화농성%체정화증상%병원%폐염극뢰백균%치료학
liver abscess,pyogenic%signs and symptoms%noxae%Klebsiella pneumoniae%therapeutics
目的：回顾性分析细菌性肝脓肿的临床和病原学特点、易发因素及治疗效果，为肝脓肿的临床诊治提供依据。方法选择2010年1月-2013年12月北京地区2所传染病医院确诊的细菌性肝脓肿患者75例，系统性分析其临床资料和病原学特点，探讨肝脓肿发生的危险因素和治疗效果。结果75例肝脓肿患者中，男55例，女20例，年龄（51.9±16.0）岁。主要临床表现为发热（52.00%）和腹痛（30.67%）。有肝病基础疾病的72例（96.00%），包括肝炎肝硬化45例（62.50%），肝癌23例（31.94%），酒精性肝病3例（4.17%），脂肪肝1例（1.39%）。其中42例（56.00%）伴随其他疾病，包括腹膜炎24例（57.14%）， AIDS 13例（30.95%），糖尿病11例（26.19%），高血压10例（23.81%）。脓液和血培养阳性率分别为46.51%（20/43）和24.39%（10/41），肺炎克雷伯菌是主要致病菌（53.33%）。45例经B超或CT引导下穿刺引流并联合抗生素治疗，有效率为88.89%。结论细菌性肝脓肿好发于老年肝病患者，男性居多，临床表现非特异性，病原菌以肺炎克雷伯菌最为常见，经B超或CT引导下穿刺引流并联合抗生素治疗可以取得良好效果。
目的：迴顧性分析細菌性肝膿腫的臨床和病原學特點、易髮因素及治療效果，為肝膿腫的臨床診治提供依據。方法選擇2010年1月-2013年12月北京地區2所傳染病醫院確診的細菌性肝膿腫患者75例，繫統性分析其臨床資料和病原學特點，探討肝膿腫髮生的危險因素和治療效果。結果75例肝膿腫患者中，男55例，女20例，年齡（51.9±16.0）歲。主要臨床錶現為髮熱（52.00%）和腹痛（30.67%）。有肝病基礎疾病的72例（96.00%），包括肝炎肝硬化45例（62.50%），肝癌23例（31.94%），酒精性肝病3例（4.17%），脂肪肝1例（1.39%）。其中42例（56.00%）伴隨其他疾病，包括腹膜炎24例（57.14%）， AIDS 13例（30.95%），糖尿病11例（26.19%），高血壓10例（23.81%）。膿液和血培養暘性率分彆為46.51%（20/43）和24.39%（10/41），肺炎剋雷伯菌是主要緻病菌（53.33%）。45例經B超或CT引導下穿刺引流併聯閤抗生素治療，有效率為88.89%。結論細菌性肝膿腫好髮于老年肝病患者，男性居多，臨床錶現非特異性，病原菌以肺炎剋雷伯菌最為常見，經B超或CT引導下穿刺引流併聯閤抗生素治療可以取得良好效果。
목적：회고성분석세균성간농종적림상화병원학특점、역발인소급치료효과，위간농종적림상진치제공의거。방법선택2010년1월-2013년12월북경지구2소전염병의원학진적세균성간농종환자75례，계통성분석기림상자료화병원학특점，탐토간농종발생적위험인소화치료효과。결과75례간농종환자중，남55례，녀20례，년령（51.9±16.0）세。주요림상표현위발열（52.00%）화복통（30.67%）。유간병기출질병적72례（96.00%），포괄간염간경화45례（62.50%），간암23례（31.94%），주정성간병3례（4.17%），지방간1례（1.39%）。기중42례（56.00%）반수기타질병，포괄복막염24례（57.14%）， AIDS 13례（30.95%），당뇨병11례（26.19%），고혈압10례（23.81%）。농액화혈배양양성솔분별위46.51%（20/43）화24.39%（10/41），폐염극뢰백균시주요치병균（53.33%）。45례경B초혹CT인도하천자인류병연합항생소치료，유효솔위88.89%。결론세균성간농종호발우노년간병환자，남성거다，림상표현비특이성，병원균이폐염극뢰백균최위상견，경B초혹CT인도하천자인류병연합항생소치료가이취득량호효과。
Objective To analyze the clinical and pathogenic characteristics, susceptible factors and treatment efficacy of the patients with pyogenic liver abscess retrospectively, so as to provide evidence for the diagnosis and treatment of pyogenic liver ab-scess. Methods A total of 75 patients with pyogenic liver abscess treated in two infectious diseases hospitals in Beijing from Jan. 2010 to Dec. 2013 were enrolled in the study. The clinical data and pathogenic characteristics were analyzed, and risk factors and treatment efficacy of pyogenic liver abscess were investigated. Results Of 75 patients with pyogenic liver abscess, 55 were males and 20 were females, and the average age was 51.9 ±16.0 years old. The major clinical manifestations were fever (52.00%) and ab-dominal pain (30.67%). Seventy-two (96.00%) patients suffered from underlying liver disease, 45 (62.50%) with liver cirrhosis, 23 (31.94%) with liver cancer, 3 (4.17%) with alcoholic liver disease and 1 (1.39%) with fatty liver. Forty-two (56.00%) patients were complicated by other diseases, 24 (57.14%) with peritonitis, 13 (30.95%) with AIDS, 11 (26.19%) with diabetes and 10 (23.81%) with hypertension. The positive rates of bacteria culture were 46.51%in pyogenic fluids and 24.39%in blood. The most frequent pathogen was Klebsiella pneumonia, accounting for 53.33%. Forty-five patients received both ultrasound B or CT-guided percutaneous drai-nage and antibiotic therapy, with the effectiveness rate of 88.89%. Conclusions Pyogenic liver abscesses mainly occurs in elderly male patients with underlying liver diseases, and has nonspecific clinical manifestations. Klebsiella pneumonia is the most common pathogen. The combination of ultrasound B or CT-guided percutaneous drainage and antibiotic therapy achieves good efficacy.
