老年糖尿病并发细菌性肝脓肿的临床特点及治疗选择

Clinical Characteristics and therapeutic strategy of pyogenic liver abscess in the senile diabetes mellitus

目的探讨老年糖尿病并发细菌性肝脓肿的临床特点、诊断和治疗要点。方法对本院收治的48例老年糖尿病合并肝脓肿患者作回顾性研究。结果老年糖尿病合并肝脓肿多见于老年男性,常合并胸、腹水,低蛋白血症等慢性合并症,血糖较难控制,临床表现不典型,易误诊。经皮肝穿刺置管引流相比传统开腹手术行脓肿引流,更具优越性。结论老年糖尿病并发肝脓肿临床表现不典型,应更重视其诊断问题。控制血糖,加强支持,及时行经皮肝穿刺置管引流应是目前最合理的治疗选择。

Objective To study the clinical characteristics of pyogenic liver abscess in the senile diabetes mellitus (DM) and the key points of the diagnosis and treatment. Methods A retrospective study was performed on 48 cases of senile DM with pyogenic liver abscess. Results Among the 48 cases, 70.8% were males. Pleural effusion, ascites, lower serum albumin were more frequently observed. The clinical features of this disorder were atypical, so the diagnosis was difficult. The percutaneous drainage is more advantageous than operation for this disorder. Conclusions The clinical features of the aged DM with liver abscesses are atypical. We should pay more attention to the diagnosis. Controling blood glucose, increasing nutrition support and taking percutaneous drainage promptly are the most reasonable therapy at present.