脾脓肿的治疗（附6例病例报告）

Treatment of splenic abscess（a case report of 6 cases）

目的：探讨脾脓肿的病因和诊治方法，以提高对该病的认识，从而获得更好的诊疗效果。方法回顾性分析2012年6月至2014年12月6例脾脓肿患者的临床资料。结果6例患者中合并2型糖尿病4例，合并外伤性脾破裂病史1例，营养不良4例。其中1例行抗感染、营养支持等保守治疗，3例行脾切除治疗，2例经彩超引导下穿刺置管引流治疗，均治愈，随访3~6个月脓肿无残留，无复发。结论高龄及合并2型糖尿病、营养不良等是脾脓肿发病的主要因素。脾切除术是多发脾脓肿的主要治疗手段，对于单发脾脓肿并且无破裂者，穿刺引流术可作为首选，若情况无改善，可行脾切除术。

Objective To investigate the etiology,diagnosis and treatment of splenic abscess,in order to improve the understanding of the disease,so as to obtain a better diagnosis and treatment effect. Methods The clinical data of six patients with splenic abscess from June 2012 to December 2014 were retrospectively analyzed. Results Among the six patients,four patients with type 2 diabetes,four pa-tients with malnutrition and one patient with traumatic rupture of spleen. All the patients were cured. One patients recovered after anti-infection and nutritional support treatment,three patients recovered by spleen resection and two patients recovered after percutaneous catheter drainage under guidance of color Doppler ultrasound. There was no relapse during 3 to 6 months of follow-up. Conclusions Type 2 dia-betes,malnutrition and age are the main factors in the pathogenesis of splenic abscess. Splenectomy is the main treatment for the patients with multiple splenic abscess,and for the patients with single splenic abscess without break,puncture drainage should be choosed preferentially.