肺炎克雷伯杆菌肝脓肿的CT表现及引流特征

CT Manifestations and Drainage Characteristics of Klebsiella Pneumoniae Induced LiverAbscess

目的比较肺炎克雷伯杆菌肝脓肿与非肺炎克雷伯杆菌肝脓肿的CT表现,探讨早期引流量差异。资料与方法337例血培养或引流液培养结果阳性患者根据培养结果分为肺炎克雷伯杆菌组(219例)与非肺炎克雷伯杆菌组(118例)。分析两组患者的CT特征,包括病灶分布、数量、结构、质地、脓肿壁厚度、肿瘤周围有无强化、是否并发血栓性静脉炎及迁徙性感染等。观察两组介入穿刺引流术的早期引流量。结果 CT显示肺炎克雷伯杆菌组多单发、多房、实性、脓肿壁薄、脓肿周围无强化、并发血栓性静脉炎及迁徙性感染(χ2=4.065、3.834、4.682、5.689、5.215、8.362、8.407,P<0.01)。肺炎克雷伯杆菌组早期引流量明显少于非肺炎克雷伯杆菌组(χ2=5.863,P<0.01)。结论肺炎克雷伯杆菌肝脓肿CT表现特点为多单发、多房、实性、脓肿壁薄、脓肿周围无强化、多见血栓性静脉炎及迁徙性感染,其介入术后早期引流量较少。

Purpose To analyze the differences of CT manifestations, and to explore the disparity of drainage volume in early drainage between Klebsiella pneumoniae induced liver abscess and non-Klebsiella pneumoniae induced liver abscess. Materials and Methods 337 cases of patients whose blood culture or drainage fluid culture results were positive were divided into Klebsiella pneumoniae group （219 cases） and non- Klebsiella pneumoniae group （118 cases）. CT characteristics of the two groups were analyzed, including lesion distribution, quantity, structure, texture, abscess wall thickness, enhancement character around the lesion, whether or not concurrent with thrombophlebitis or migratory infection and so on. Early drainage volume in interventional puncture drainage was observed in both groups. Results Chest CT showed that solitary, multi-room, solid, thin-walled abscesses with concurrent thrombophlebitis, migratory infection and no enhancement around tend to occur in Klebsiella pneumoniae group （X2=4.065, 3.834, 4.682, 5.689, 5.215, 8.362, 8.407, P〈0.01）. Early drainage volume of Klebsiella pneumoniae group was significantly lower than that of non-Klebsiella pneumoniae group 0（z-5.863, 1~〈0.01）. Conclusion CT manifestations of Klebsiella pneumoniae induced liver abscess are solitary, multi-room, solid, thin-walled abscesses without enhancement around them, thrombophlebitis and migratory infection are common seen and drainage volume is less in early stage after interventional operation.