糖尿病合并细菌性肝脓肿的临床特点及外科治疗

目的：探讨糖尿病合并细菌性肝脓肿的临床特点、诊断及外科治疗。方法：对外科治疗的32例糖尿病合并细菌性肝脓肿患者作回顾性分析。结果：有典型症状者仅14例，不典型症状者18例；好发于血糖控制不良的患者；脓液细菌培养阳性率较低。单纯用抗生素治疗10例，B超引导经皮肝穿刺置管引流8例，手术治疗14例，治愈29例，死亡3例，主要死因为多器官功能衰竭。结论：糖尿病合并细菌性肝脓肿临床表现不典型，诊断首选B超检查，在严格控制血糖，加强营养支持，选择合适治疗方案完全可以达到理想的外科治疗效果。

Clinical characteristics and surgical treatment of bacterial liver abscess in diabetes

Objective:To explore the clinical features,diagnosis and surgical treatment of bacterial liver abscess in diabetes.Methods:32 cases of bacterial liver abscess of diabetics were studied retrospectively.Results: Typical clinical manifestations were found only in 14 cases and 18 cases were atypical.Generally,the patients under bad control of blood glucose had an attack of this disease.The rate of positive reaction of the culture of bacteria was low.10 cases were treated by antibiotics alone,eight cases submitted to percutaneous drainage and 14 cases underwent abdominal exploration.29 cases recovered after treatment with three cases died.The multiple organ failure were the main causes of death.Conclusion: Clinical features of bacterial liver abscess in diabetics are atypical.Abdominal B tpye ultrasonography is the first selected method in the diagnosis.If the patient's blood glucose is well controlled and adequate nutrition is provided,the effect of surgical treatment on this disease will be very gratified.