糖尿病合并细菌性肝脓肿的临床特点及外科治疗

Clinical characteristics and surgical treatment of bacterial liver abscess in diabetes

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 1 4例 ,不典型症状者 1 8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 1 0例 ,B超引导经皮肝穿刺置管引流 8例 ,手术治疗 1 4例 ,治愈 2 9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 。

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.