摘要
目的总结近7年该院收治的细菌性肝脓肿(BLA)患者的临床特征和细菌学特点,为及时、准确诊治该病提供帮助。方法对2012年1月至2018年12月该院确诊的166例BLA患者的临床和实验室资料进行回顾性分析。结果166例患者中男123例(74.10%),女43例(25.90%),平均年龄(58.42±5.23)岁,发热(95.78%)、腹痛(62.05%)是其最常见的临床表现。肺炎克雷伯菌(65.14%)和大肠埃希菌(21.10%)是主要的致病菌。将107例细菌学培养阳性肝脓肿分为肺炎克雷伯菌组(70例)与非肺炎克雷伯菌组(37例),比较发现肺炎克雷伯菌组常见合并糖尿病(χ^2=6.557,P=0.01),而非肺炎克雷伯菌组更多合并有胆道系统疾病(χ^2=11.899,P<0.05)、腹部手术史(χ^2=20.103,P<0.05)。引起肝脓肿的致病菌表现为低耐药率,但同时发现产超广谱β-内酰胺酶阳性致病菌22株。抗菌药物联合经皮肝穿刺置管引流术是最常见的治疗手段。结论该院BLA患者临床表现大多不典型,肺炎克雷伯菌及大肠埃希菌是最常见的致病菌。根据影像学及药敏试验结果及时选择合适的治疗方案,预后较好。
Objective To summarize the clinical and bacteriological characteristics of the patients with bacterial liver abscess admitted and treated in this hospital during the past 7 years so as to provide help for timely and accurate diagnosis and treatment of the disease.Methods The clinical and laboratory data of 166 patients with bacterial liver abscess diagnosed in this hospital from January 2012 to December 2018 were retrospectively analyzed.Results Among 166 cases of bacterial liver abscess,123 cases(74.10%)were male and 43 cases(25.90%)were female.The average age was(58.42±5.23)years old.Fever(95.78%)and abdominal pain(62.05%)were the most common clinical manifestations.Klebsiella pneumoniae(65.14%)and Escherichia coli(21.10%)were the main pathogens.One hundred and seven cases of bacterial liver abscess were divided into the Klebsiella pneumoniae group(KP group,70 cases)and non-Klebsiella pneumoniae group(nKP group,37 cases).The comparison between the two groups found that complicating diabetes mellitus was common in the KP group(χ^2=6.557,P=0.01),while the biliary tract diseases(χ^2=11.899,P<0.05)and abdominal surgery history were more common in the nKP group(χ^2=20.103,P<0.05).The pathogenic bacteria causing liver abscess showed a low drug resistance rate,but 22 strains of ESBLS-positive pathogenic bacteria were found at the same time.Antibiotics combined percutaneous transhepatic catheter drainage was the most common treatment method.Conclusion Most of the clinical manifestations of bacterial liver abscess in this hospital are atypical.Klebsiella pneumoniae and Escherichia coli are the most common pathogens.According to the results of imaging and drug sensitivity test,timely selection of appropriate treatment regimen has good prognosis.
作者
陈梅
张莉
赵久法
CHEN Mei;ZHANG Li;ZHAO Jiufa(Department of Hospital Infection,First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China)
出处
《现代医药卫生》
2020年第5期691-695,共5页
Journal of Modern Medicine & Health
基金
蚌埠医学院第一附属医院科技发展基金项目(BYKF1759)
关键词
细菌性肝脓肿
临床特征
肺炎克雷伯菌
大肠埃希菌
病原学
Bacterial liver abscess
Clinical features
Klebsiella pneumoniae
Escherichia coli
Etiology
