细菌性肝脓肿外科处理的临床分析

Analysis of bacterial liver abscess in surgical treatment

目的总结细菌性肝脓肿的诊治经验。方法对我院从1992年～2002年十年间所收治的105例细菌性肝脓肿病人进行回顾性分析。本组治疗方法包括:单纯抗生素治疗21例,外科手术引流30例,腹腔镜手术引流6例,经皮穿刺抽吸治疗42例,经皮穿刺置管引流治疗6例。结果本组治愈101例,死亡4例,死亡率3.8%。结论早期诊断和恰当的治疗是提高细菌性肝脓肿疗效的重要因素,超声引导下穿刺抽吸和/或置管引流已成为细菌性肝脓肿的治疗首选,适合于大部分病人。而外科手术引流仅适合于介入治疗失败或脓肿破裂病人。

Objective To summarize the experience of diagnosis and treatment of bacterial liver abscess. Methods From 1992 to 2002,105 patients with bacterial liver abscess were analysed retrospectively. Therapeutic methods were as follows:Simple antibiotic treatment was in 21cases,surgical drainage 30 cases(Among them,9cases were elective operation),laparoscopic drainage 6 cases, percutaneous aspiration 42 cases,and percutaneous catheterization drainage 6 cases. Results 101cases were cured,and 4cases died from multiple organ dysfunction symdrome (MODS).The mortality rate was 3.8%. Conclusion Early diagnosis and correct treatment are important factors to improve the curative effect of bacterial liver abscess. Ultrasound-guided aspiration and catheterization drainage are the measure of first choice for treating the bacterial live abscess,and it is conformable to most patients.The surgical drainage is suitable only to fail of interventional treatment and rupture of abscess.