糖尿病合并肝脓肿的外科诊治

THE DIAGNOSIS AND SURGICAL TREATMENT OF LIVER ABSCESS ASSOCIATED WITH DIABETES MILLITUS

目的 糖尿病患者肝脓肿的诊治经验。方法 对 14例糖尿病合并肝脓肿患者临床资料回顾性分析。结果 糖尿病合并肝脓肿占同期收治肝脓肿的 36 .84 % ,血糖控制不理想、临床表现不典型、脓肿液化不明显是本病的主要特点。本组 3例行 B超引导下穿刺引流 +抗生素冲洗治愈 ,平均住院 31± 1.7d,11例厚壁脓肿行手术脓肿局部切除 ,平均住院 2 0± 1.7d两者比较差异有显著意义 (P<0 .0 1)。结论 糖尿病患者肝脓肿临床不少见 ,多为厚壁脓肿 ,脓肿局部切除术是治疗本病的重要方法且安全有效 。

Objective To summarize the experience of diagnosis and surgical treatment of liver abscess associated with diabetes millitus.Methods The treatments of 14 patients with liver abscess associated with diabetes millitus were retrospectively reviewed.Results The ratio of liver abscess associated with diabetes millitus to the total liver abscess of the same period is 36.84%,unsatisfied control of blood sugar,untypical clinical manifestation and un notable abscess colliquation are the mean behaviors of these patients.3 patients were successfully treated by B ultrosound guided needle drainage and irrigationed with antibiotics,with 31±3.7 d of mean hospital staying,and the remaining 11 patients were successfully treated by local resection of liver abscess,with 20±1.7 d of mean hospital staying.The difference of hospital staying between the patients underwent the two different treatments is significant(p<0.01).Conclusion Liver abscess associated with diabetes millitus is not rare on clinical and the wall of the abscess is always thick.Local hepatic resection to remove the liver abscess is an important treatment for these patients.The operation is safety and effective and the period of hospital staying can be shorten significantly.