细菌性肝脓肿合并血流感染的临床特点及其相关危险因素分析

Clinical Characteristics and Related Risk Factors of Bacterial Liver Abscess Complicated with Bloodstream Infection

目的:探讨分析细菌性肝脓肿(PLA)合并血流感染的临床特点及其相关危险因素。方法:选取笔者所在医院在2016年1月-2019年12月确诊并治疗的肝脓肿患者94例,其中合并血流感染患者31例设为作为研究组;未合并血流感染患者63例设为对照组。通过医院电子病历档案来对两组的相关临床资料,如实验室指标、影像学检查、临床症状及合并症情况等进行整理及统计;同时应用Logistic回归方程进一步分析导致PLA合并血流感染的相关独立风险性因素。结果:研究组合并恶性肿瘤、合并糖尿病、白蛋白<40 g/L、SOFA评分≥2分、空腹血糖<7.0 mmol/L、白细胞计数>10×10^(9)/L、尿素氮≥7.1 mmol/L、血总胆红素≥34.2 μmol/L、脓肿个数≥2个、脓肿直径≥10 cm占比均显著高于对照组(P<0.05),研究组既往胆道感染史低于对照组(P<0.05)。多因素分析结果显示,影响PLA合并血流感染发生的相关独立风险性因素为白蛋白<40 g/L、脓肿直径≥10 cm(P<0.05)。结论:导致PLA患者合并血流感染的相关独立危险因素为脓肿直径≥10 cm、白蛋白<40 g/L,临床可依据相关风险性因素来实施针对性防控措施,从而提高PLA患者的预后。

Objective:To investigate the clinical characteristics and related risk factors of bacterial liver abscess (PLA) complicated with bloodstream infection.Method:A total of 94 patients with liver abscess diagnosed and treated in our hospital from January 2016 to December 2019 were selected,in which 31 patients with PLA complicated with bloodstream infection were selected as the research group,63 cases of PLA patients without bloodstream infection were selected as the control group.The relevant clinical data of the two groups,such as laboratory indicators,imaging examination,clinical symptoms and complications were sorted out and statistically analyzed through the hospital electronic medical records.At the same time,the independent risk factors leading to PLA complicated with bloodstream infection were further analyzed by logistic regression equation.Result:The proportion in the research group of combination with malignant tumor,diabetes,albumin <40 g/L,SOFA score ≥2 points,fasting blood glucose ≥7.0 mmol/L,white blood cell count >10×10^(9)/L,blood urea nitrogen ≥7.1 mmol/L,total bilirubine TBIL ≥34.2 μmol/L,number of abscesses ≥2,diameter of abscesses ≥10 cm were significantly higher than those of the control group (P<0.05).The history of biliary tract infection in the research group was lower than that in the control group (P<0.05).The results of multivariate analysis suggested that the related independent risk factors affecting the occurrence of PLA combined with bloodstream infection were albumin 40 g/L and abscess diameter ≥10 cm (P<0.05).Conclusion:The relevant independent risk factors that lead to PLA patients with bloodstream infection are abscess diameter ≥10 cm and albumin <40 g/L.Targeted prevention and control measures can be implemented based on relevant risk factors to improve the prognosis of PLA patients.