85例老年细菌性肝脓肿的临床特点分析

目的 总结85例老年细菌性肝脓肿的临床特点,为临床治疗提供依据. 方法 回顾我院1989年1月至2009年12月收治的206例细菌性肝脓肿的临床资料,根据患者年龄将其分为老年组(≥60岁)与非老年组(＜60岁),比较2组间临床表现、实验室与影像学检查以及治疗和预后的特点. 结果 与非老年组相比,老年组患者常伴有内科基础疾病,且血清肌酐水平( 115.1±44.2) mmol/L比(88.5±37.3) mmol/L,P＜0.01]、APACHEⅡ评分(8.7±4.1)分比(6.2±4.0)分,P＜0.05]显著升高,且多发、双叶肝脓肿较非老年组多见(32.9％比20.7％,18.8％比8.3％,P均＜0.05).经积极治疗后,老年组患者住院时间、并发症发生率、病死率与非老年组无显著差别(P均＞0.05). 结论 老年肝脓肿患者临床表现、实验宣与影像学检查有其自身特点,经积极治疗可获得与非老年患者相同的预后.

Clinical features of 85 elderly patients with pyogenic liver abscess

Objective To summarize the clinical features and management of 85 elderly patients with pyogenic liver abscess.Methods Two hundred and six patients with pyogenic liver abscess were enrolled from January 1989 to February 2009 and were divided into elderly group(≥60 years) and younger group.The data of the clinical features,laboratory examination,imaging and microbiological examinations,treatment and outcome were analyzed between 2 groups.Results Compared with younger group,the incidence of associated diseases and the levels of serum creatinine(115.1±44.2 mmol/L vs 88.5±37.3 mmol/L,P<0.01) and APACHE Ⅱ score(8.7±4.1 vs 6.2±4.0,P<0.05) in elderly group were higher.Multiple abscess and bilobar abscess were more often found in elderly group than younger group(32.9% vs 20.7%,18.8%vs 8.3%,P<0.05).There were no significant differences in the length of hospital stay,overall complication rate and hospital mortality rate between 2 groups(P>0.05).Conclusions Elderly patients with pyogenic liver abscess have their own characteristics in clinical and laboratory presentation.Active management is tolerated well,with the same prognosis in young patients.