70例细菌性肝脓肿的诊治体会

目的 总结细菌性肝脓肿的诊治经验。方法 回顾性分析1992年至今诊治的70例细菌性肝脓肿患者的临床资料。结果 高龄病人、糖尿病病人、胆石症病人为细菌性肝脓肿的高发人群，右上腹痛、寒战高热、右上腹压痛与肝区叩痛是细菌性肝脓肿的主要临床表现，绝大多数病人的血常规检查为炎症表现，影像学诊断应首选B超检查，大部分细菌性肝脓肿可在B超引导下经皮肝脓肿穿刺置管引流而治愈。结论 细菌性肝脓肿近来有增多的趋势，提高认识，仔细查体，综合分析，是提高确诊率的关键。

THE DIAGNOSIS AND SURGICAL TREATMENT OF BACTERIAL LIVER ABSCESS:EXPERIENCE IN 70 CASES

Objective To summarize the experience of diagnosis and surgical treatment of bacterial liver abscess.Methods The diagnosis and treatments of 70 patients with bacterial liver abscess were retrospectively reviewed.Result Aged patients and gallstone patients and patients with diabetes mellitus were among high-risk population for bacterial liver abscess.The main clinical manifestations and signs were pains in the right upper abdomen,fever,tenderness of right upper abdomen,hepatic tenderness.Blood routine showed acute inflammation in most cases.B-Ultrsonography should be the first choice for diagnosis. Percutaneous and transhepatic cholangiography drainage of bacterial liver abscess can be used for most cases,which is simple and safe.Conclusion In recent years,the complication of this disease has increased remarkably.The key to increase the confirmed diagnosis rate was paying more attention to the clinical manifestations,physical examination and synthetical analysis.