25年间我院肝脓肿的临床特点变迁及治疗研究

Retrospective study on the changes of clinical features of liver abscess in our hospital during the past 25 years

目的探讨1991年6月-2016年5月25年间我院肝脓肿临床特点及变迁。方法将我院1991年6月-2016年5月收治的肝脓肿患者180例依据入院时间分为A、B、C三组,对其发病年龄、致病因素、病原学、治疗方法、抗生素选择及转归进行比较。结果 25年间,发病平均年龄逐渐升高,原发疾病以胆道疾病、糖尿病居多,其次为肝外伤、结肠炎等,培养细菌主要为大肠埃希菌及肺炎克雷伯菌。经皮穿刺引流结合抗感染治疗是治疗细菌性肝脓肿的主要方法。结论 25年间肝脓肿发病例数无明显减少;随着细菌耐药增加,抗生素逐年升级;治疗肝脓肿的关键在于及时合理使用抗生素以及恰到时机的介入治疗等。

Objective To investigate the clinical features and changes of liver abscess in our hospital from Jun. 1991 to May. 2016. Methods One hundred and eighty patients with liver abscess were divided into three groups according to the admission time. Age of onset, pathogenic factor, etiology, therapeutic method, antibiotic choice and prognosis were compared among 3 groups. Results Among the last 25 years, the average onset age became older. The most primary diseases were biliary diseases and diabetes mellitus, and the others in order were liver trauma, colitis and so on. The cultured bacteria were mainly Escherichia coli and Klebsiella pneumoniae. Percutaneous drainage combined with anti-infection treatment was a chief therapy for liver abscess. Conclusion There were no significant reduction in the number of patients over the last 25 years. With the increase of bacterial drug resistance, the antibiotics had been upgraded year by year. The key to the treatment of this disease is the rational use of antibiotics and the timing of interventional therapy.