细菌性肝脓肿合并胸膜炎与其复发的相关性

目的分析细菌性肝脓肿合并胸膜炎与其复发的相关性，探讨胸膜炎在细菌性肝脓肿复发过程中可能的作用机制，为预防细菌性肝脓肿的复发提供临床依据。方法回顾分析2011年12月至2015年4月期间治愈出院的219例细菌性肝脓肿患者的临床资料。结果细菌性肝脓肿合并胸膜炎组患者肝脓肿的复发率明显高于非胸膜炎组（P〈0．05），而且与非胸膜炎组比较，胸膜炎组的C反应蛋白（CRP）水平、肝脓肿的最大直径显著升高（P〈0．05）。多因素Logistic回归分析结果提示在校正了性别、年龄、CRP、脓肿最大直径、糖尿病等6种基础疾病等因素影响的情况下，细菌性肝脓肿合并胸膜炎是其复发的危险因素，OR值为4．783（P〈0．01）。结论细菌性肝脓肿合并胸膜炎与细菌性肝脓肿的复发密切相关，且是其复发的独立危险因素。

Objective To analyze the association of pyogenic liver abscess with pleurisy with recurrence and to discuss the possible mechanisms responsible for the formation of the recurrence of pyogenic liver abscess. Methods Clinical data of 219 patients with bacterial liver abscess cured and discharged from April 2015 to December 2011 were analyzed retrospectively. Results The recurrence of pleurisy group was significantly higher than non-pleurisy group （ P〈0.05 ） ; furthermore, compared with non-pleurisy group, the CRP levels and maximum diameter of abscess in pleurisy group were higher （ P〈0.05 ） ; Logistic regression analysis showed that pyogenic liver abscess with pleurisy was a risk factor for recurrence （ OR=4.783, P〈 0.01 ） , after adjusting for gender, age, diabetes mellitus, biliary stone, coronary heart disease, tumor, pulmonary tuberculosis. Conclusions Pyogenic liver abscess with pleurisy is closely associated with recurrence, and is an independent risk factor for the recurrence of pyogenic liver.