肝脓肿溃破77例分析

肝脓肿溃破是肝脓肿的主要并发症。作者总结该院近３０年来收治的肝脓肿溃破７７例，发现其几乎可破向肝周所有邻近脏器。导致肝脓肿溃破的原因包括就诊过晚、误诊、漏诊和处理不力等。提出预防肝脓肿溃破的关键是提高对本病的认识、早期诊断和及时有效的引流。认为经腹引流是最佳途径。大多数患者在肝脓肿溃破后需手术引流，同时经网膜静脉或脐静脉插管滴注有效抗生素。肝脓肿溃破的预后凶险，死亡率高，本组达３５．１％（２７／７７），死亡率与溃破所致的并发症密切相关。

RUPTURE OF LIVER ABSCESS:ANALYSIS OF 77 CASES

Rupture is one of main complications of liver abscess. Seventy-seven patients with rupture of liver abscess are reviewed. Liver abscess may freely rupture into adjacent structures or organs or serous cavities and cause various complications. The causative factors of rupture of liver abscess in this series were late medical consultation in the course of the disease,delayed treatment due to misdiagnosis,and improper treatment. Measures that prevent rupture of liver abscess include raising clinical awareness of early diagnosis and timely effective drainage. The authors consider that transperitoneal surgical drainage is the best approach. Most patients with rupture of liver abscess should be treated by surgical drainage togather with transomental or transumbilital veno-catheterization for antibiotic infusion. Patients with rupture of liver abscess usually present a poor prognosis and a high mortality rate. The mortality in this group was 35. 1% (27/77),which is closely related to the complications of the rupture of liver abscess.