糖尿病合并细菌性肝脓肿的诊断和治疗

The Treatment of Baceterial Liver Abscess in Diabetics.

目的:探讨糖尿病合并细菌性肝脓肿的临床特点,以提高治疗水平。方法:对54例患者的临床资料进行回顾性分析。结果:糖尿病合并细菌性肝脓肿不明感染源者占63.0%。有典型症状者仅53.7%。并发感染性休克和急性肾功能不全者各5例,酮症酸中毒和高渗性昏迷各2例,肝脓肿溃破而致腹膜炎1例。单纯用抗生素治疗者20例,B超引导经皮肝穿刺置管引流17例,手术治疗17例。治愈51例(94.4%),死亡3例。结论:糖尿病合并细菌性肝脓肿发病隐匿,严重并发症多,易误诊误治。早期诊断、控制血糖、适时脓肿引流和有效抗生素应用是治疗成功的关键。

ve:To investigate the clinical characteristics of bacterial liver abscess(BLA) in diabetics inorder to the improve of the therapeutic results. Methods: The clinical data of 54 cases were reviewedretrospectively. Results: The underlying source of infection was not known in 63% of the cases. Typi-cal clinical manifestations were found only in 53.7% of patients. Their complications included septicshock(5 cases), acuted renal dysfunction(5 cases), diabetic ketoacidosis(2 cases), hyperosmolar coma(2cases) and acute diffuse peritonitis(1 cases). Twenty cases were treated by antibiotics alone, 17 casessubmitted to percutaneous drainage and 17 underwent abdominal exploration. Conclusions: BLA ac-companying diabetes mellites often presents serious complications. Appropriate therapy includes earlydiagnosis, control of hyperglycemia, exteral drainage and use course of antibiotics.