肝脓肿的临床分析

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1、万方数据88肝脓肿的临床分析毕文俊范竹萍尘堡趟垡垒一盘!!丛堕至兰监堡盟羔盟—!兰!旦』堕g：坠!!!!!!!：!!!!!!!!：!!!型!：!【摘要】目的加强对肝脓肿的认识，为临床诊疗[作提供参考。方法阀顿性分析】02例肝脓删，病例，总结其临床特性：和诊疗情况。结果患者临床表现巾发热最为多见(94例．92．2％)，其次为艮寒、寒战(49例。48．0％)、腹痛(44例．43．1％)等。外J剐虮自细胞7t高者占55．9％(57例)。m系疾病(45例，44．1％)和糖尿病(41例。40．2％)是主要发病因素。

2、胆道是主要感染途径．另有部分为隐源性，39例隐源性者中19例合并糖尿病。首选诊断方法为B超(诊断率7(／．6％)。但有7例(6．9％)患者通过B超、CT、MRI检查仍未获确诊，需行经皮肝穿刺或剖腹探查。56％(75例中42例)的患着细菌培养阴性。所获41株细菌中以肺炎克雷伯杆煎为主(63．4％)㈡】E胺培南、舒巴坦{头孢哌酮、舒巴坦十氨皆西林、阿米卡星、头孢他啶、头孢吡肟对雏兰15Ij性蔚较为敏感(敏感性>9()％)。玎占霉素、替考拉宁对革兰阳性菌较为敏感(敏感性100％)。结论糖尿病患者易发肝脓肿。【关

3、键词】肝脓肿；胆系疾病；糖尿病ClinicalanalysisofliverabscessesHIWe，l一，“n，FANZ／tu—ping．1)epartmentof⋯Gastroenterology，RenjiHospital，ShanghaiInstitute(

4、}DigestireDisease，(?ollege0fMedi(

5、。ine，Shangka。IiaotongUniversity，Shanghat200001，ChinaCorresponaingauthot。：FANZhu—ping，E

6、mail：zkuping一

7、cIn@163．cnfn[Abstract]0bjectiveTofurlherunderslandliverat)seesses，SOastoguidetheclinicalwork．Methods’l'heclinicaldataof102patientswithlivera1)scesseswereretrospe(’tivelyanalyzed．TheclinicalfeaturesofthepatientsandtreatmentVvereSOIniTIalized．

8、ResultsThepatientsusuallypresentedwithfever("一94，92．2％)，chillandrigor(n=49，48．0％)andabdominalpain(n一44，43．1％)．Among102patients，57(55．9％)hadleukoeytosis．BiliarytJactdiseasesanddiabetesmellituswerecommonunderlyingdiseasedfoundin45(44．1％)and11(40．2‰)patients

9、withli、7el-a1)sccsse一，respeclively．Theinfectionwerenlolec0121InODl)foundviabiliarytraclthanviacryplogerfic．Uhrasonographywasthefirstchoicefordiagnosisoftheliverabscessed(diagnoslicrate70．6‰)．But八6．9％)paltentswhofaileddiagnoseswithultrasonography，(”rorMRim

10、agewereperformedultrasollographyguidedperculancotlsaspirationorsurgicaloperation．Negativegcrmieultureswereidelllifiedin56％(42／75)otpatients．Forty--onestrainswereisolatedandKlebsiellapneumoniae(6：；．4％)wasthemostpredominat．Thesensitiwtiesof(；ramnegativebaci

11、llitoimipenem，sulperazon，unasyn，amikaein，cettazidime，cefepimewere>90％，whilethesensitMtiesofGratnpositiveCOCCLIStOVail(’omycinandteieoplaninWt2FC100％．ConclusionPatientswithdiabetesmellitLISaresu,hceptil)kIolivel+a1)s