48例细菌性肝脓肿临床分析

目的探讨近年来细菌性肝脓肿的临床表现、病原菌、诊断和治疗变化。方法回顾性分析了我院近１０年的４８例患者。结果本病近年患病率和死亡率下降。临床表现和体征多不典型。胆系结石和肿瘤已取代以往的胆道蛔虫成为主要致病因素（２９．２％）。糖尿病患者易并发本病（８．３％）。细菌培养阴性的病例有所增加（５２．１％）。诊断应首选Ｂ超检查（确诊率７９．２％）。经皮脓肿穿刺或引流合并抗生素的应用为有效治疗方法。感染性休克为主要并发症及死亡原因。结论本病近年来表现趋于不典型,诊断较困难,临床上应引起重视。

Clinical features and changing trends of bacterial liver abscess: analysis of 48 cases

Objective To analyse and compare the changing of clinical feature, pathogenic bacteria, and so is diagnosis and treatment of bacterial liver abscess up date Methods Retrospective study of forty eight patients over 10 years in PUMC hospital. Results Compared with the patients in 1960s, the complication and mortality of this disease decreased remarkably. The main clinical manifestations and signs became less typical. Cholelithes and tumor of biliary tract instead of biliary ascariasis became chief pathogenic factor (29.2%). Patients with diabetes mellitus complicating bacterial liver abscess tended to increase (8.3%). The case with negative bacterial culture has increased (52.1%). Ultrasonography should be the first choice for diagnosis, the confirmed diagnosis rate is 79.2% . Percutaneous drainage of the abscess and combined using antibiotics are the effective treatment method. Septic shock was the chief complication causing death. Conclusions This disease becomes less typical and difficult to early diagnosis attention should be paid to clinical medicine.