肺炎克雷伯菌肝脓肿合并脓毒性肺栓塞30例临床分析

Septic pulmonary embolism caused by Klebsiella pneumoniae liver abscess:report of 30 cases

目的总结30例肺炎克雷伯菌肝脓肿合并脓毒性肺栓塞的病例资料并进行相关文献复习,以提高对该疾病的认识,及早进行有效的治疗.方法回顾性分析2013年8月-2019年12月30例肺炎克雷伯菌肝脓肿合并脓毒性肺栓塞患者的临床特点、实验室和影像学检查结果、治疗及转归,并复习相关文献.结果30例患者均有肝外血运播散性病灶,均合并脓毒性肺栓塞,30例中23例合并有糖尿病,其中2例为1型、21例为2型糖尿病;3例合并眼内炎;1例合并细菌性腹主动脉瘤破裂.结论肺炎克雷伯菌肝脓肿合并脓毒性肺栓塞好发于糖尿病人群,常伴严重并发症,病情进展快,及早诊断并治疗至关重要.

Objective To analyze the clinical data of 30 cases of septic pulmonary embolism caused by K.pneumoniae liver abscess and to review relevant literature for better understanding and early effective treatment of this disease.Methods We reviewed the clinical manifestations,imaging findings,treatment courses of 30 patients diagnosed with septic pulmonary embolism caused by K.pneumoniae over a period of 6 years.The relevant literature was reviewed.Results All the 30 patients had extrahepatic disseminated lesions in addition to liver abscess,and complicated with septic pulmonary embolism.23 patients were complicated with diabetes mellitus,including type 1 diabetes in 2 cases and type 2 in 21 cases.Three patients had concomitant endophthalmitis.One patient was complicated with rupture of bacterial abdominal aortic aneurysm.Conclusions Septic pulmonary embolism caused by K.pneumoniae often occurs in diabetic patients,associated with serious complications.The syndrome progresses rapidly.Early diagnosis and treatment are very crucial.