细菌性肝脓肿的病原检测及其诊治

Pathogen detection and clinical management on bacterial liver abscess

目的分析260例细菌性肝脓肿的病原及其诊治。方法回顾性分析260例细菌性肝脓肿临床特点,病原学分布及诊断与治疗方法。结果肝脓肿的主要临床表现为寒战、发热,肝区疼痛。培养所获细菌96株,其中肺炎克雷伯氏菌、大肠埃希氏菌分别占67.7%和11.5%。内科保守治疗89例,B超引导下肝脓肿穿刺抽脓或置管引流142例,肝脓肿切开引流11例,肝叶切除18例。除1例因合并晚期肿瘤死亡,其余病例均获得良好疗效。结论肺炎克雷伯氏菌、大肠埃希氏菌已成为细菌性肝脓肿的优势菌。胆道疾病是细菌性肝脓肿的主要病因。糖尿病是细菌肝脓肿最重要的危险因素。B超引导下肝脓肿穿刺抽脓或置管引流是主要的治疗手段。

The etiology and clinical management on 260 patients with bacterial liver abscess admitted to the Union Hospital of Fujian Medical University from Jan, 2001 to Mar. 2008 were investigated. Among the 96 strains of bacteria isolated, Kleibsiella pneumonia and Escherchia coli were the most predominant organisms with the isolation rates of 67.7 % and 11.5 respectively. Among these cases,89 cases received medical treatment with antibiotics; 142 cases were treated with percutaneous aspiration or indwelling catheter drainage guided with ultra-sound, 11 cases were treated by surgical intervention with aspiration and 18 eases received hepatolobectomy. All patients received treatment were cured except one death of patient treated.