以不明原因发热为表现的细菌性肝脓肿96例临床病例分析

Pyogenic hepatic abscess in patients with fever of unknown origin: A clinical analysis of 96 cases

  • 摘要: 目的 总结细菌性肝脓肿的临床特点及诊断。 方法 对2008年10月- 2013年11月就诊我科的不明原因发热病例中96例细菌性肝脓肿患者临床资料进行回顾性分析。 结果 本组96例中,年龄17 ~ 85(35.53±8.92)岁,男49例,女47例。来诊后确诊时间1 ~ 7 d,平均2.3 d。临床表现主要症状有寒战91例(94.29%),间歇热59例(61.46%)。既往有糖尿病病史39例(40.62%),糖尿病合并肺炎15例,与非糖尿病患者比较差异有统计学意义(P< 0.01)。96例均进行脓液培养和微创治疗,引流液培养阳性84例(87.50%),其中肺炎克雷伯菌53例(55.21%)。 结论 间歇热是细菌性肝脓肿的发热特点,结合实验室检查和影像学检查能及早确诊细菌性肝脓肿;引流液的性状为经验性的治疗提供了依据。糖尿病患者患肝脓肿时易合并肺部感染。

     

    Abstract: Objective To summarize the clinical diagnosis of pyogenic hepatic abscess. Methods Clinical data about 96 patients with pyogenic hepatic abscess admitted to our hospital from October 2008 to November 2013 were retrospectively analyzed. Results The age of these 96 patients (49 male and 47 female) was 35.53±8.92 years on average, ranged from 17 to 85 years. Patients needed generally 1-7 d to get the clear diagnosis with an average of 2.3 d. 91 cases (94.29%) had shiver as the main symptoms. Intermittent fever was found in 59 cases (61.46%). There were 39 cases who had history of diabetes, among them 15 cases were complicated with pneumonia, the difference was statistically signi ficant compared with non-diabetes cases. All 96 cases were treated with pus culture and minimally invasive treatment, 84 cases (87.50%) had positive culture of the drainage liquid, including 53 cases of K. peneumoniae (55.21%). Conclusion Intermittent fever is the heating characteristics of bacterial liver abscess which can be diagnosed timely when combining with the examinations of laboratory and imaging. Properties of drainage liquid can provide basis for empirical therapy. Patients with diabetes who suffer from pyogenic hepatic abscess are vulnerable to lung infection.

     

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