Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and ...Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology.In this article,we aim to elaborate these differences and their therapeutic implications.Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA),there are clear differences in the microbiological spectrum,which implies different risk factors and disease courses.Klebsiella pneumoniae (K.pneumoniae) PLA is predominantly seen in Southeast Asia,whereas,in Central Europe,PLA is typically caused by Escherichia coli,Streptococcus or Staphylococcus,and these patients are more likely to be older and to have a biliary abnormality or malignancy.K.pneumoniae patients are more likely to have diabetes mellitus.Control of septic spread is crucial in K.pneumoniae patients,whereas treatment of the underlying diseases is decisive in many Central European PLA patients.展开更多
目的:分析总结妊娠期及产后妇女合并急性胰腺炎的临床特征及诊疗经验。方法:回顾性分析1994年至2012年间北京大学第三医院收治的妊娠期及产后合并急性胰腺炎患者,共18例次,总结其临床特点及诊疗过程。结果:与同期产科住院患者人数相比,...目的:分析总结妊娠期及产后妇女合并急性胰腺炎的临床特征及诊疗经验。方法:回顾性分析1994年至2012年间北京大学第三医院收治的妊娠期及产后合并急性胰腺炎患者,共18例次,总结其临床特点及诊疗过程。结果:与同期产科住院患者人数相比,本组18例次患者所占比例为41.24/10万,年龄32.0(28.0,34.7)岁,妊娠35.0(23.5,37.0)周发病。间质水肿性胰腺炎13例(72.2%),坏死性胰腺炎5例(27.8%)。病因构成中,9例(50.0%)由高脂血症所诱发,7例(38.9%)为胆源性,2例(11.1%)为特发性。按照严重程度划分,轻症6例(33.3%),中等重症7例(38.9%),重症5例(27.8%),8例转入重症监护病房(Intensive Care Unit,ICU)治疗。与非高脂血症性相比,高脂血症性胰腺炎患者的病情更加严重,但母婴预后无明显差异。结论:妊娠及产后合并急性胰腺炎的发病率与普通人群大致一致,主要由胆石症及高脂血症引起。高脂血症性胰腺炎的病情更为严重,但经过积极治疗仍可以有效改善患者预后。展开更多
文摘Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology.In this article,we aim to elaborate these differences and their therapeutic implications.Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA),there are clear differences in the microbiological spectrum,which implies different risk factors and disease courses.Klebsiella pneumoniae (K.pneumoniae) PLA is predominantly seen in Southeast Asia,whereas,in Central Europe,PLA is typically caused by Escherichia coli,Streptococcus or Staphylococcus,and these patients are more likely to be older and to have a biliary abnormality or malignancy.K.pneumoniae patients are more likely to have diabetes mellitus.Control of septic spread is crucial in K.pneumoniae patients,whereas treatment of the underlying diseases is decisive in many Central European PLA patients.
文摘目的:分析总结妊娠期及产后妇女合并急性胰腺炎的临床特征及诊疗经验。方法:回顾性分析1994年至2012年间北京大学第三医院收治的妊娠期及产后合并急性胰腺炎患者,共18例次,总结其临床特点及诊疗过程。结果:与同期产科住院患者人数相比,本组18例次患者所占比例为41.24/10万,年龄32.0(28.0,34.7)岁,妊娠35.0(23.5,37.0)周发病。间质水肿性胰腺炎13例(72.2%),坏死性胰腺炎5例(27.8%)。病因构成中,9例(50.0%)由高脂血症所诱发,7例(38.9%)为胆源性,2例(11.1%)为特发性。按照严重程度划分,轻症6例(33.3%),中等重症7例(38.9%),重症5例(27.8%),8例转入重症监护病房(Intensive Care Unit,ICU)治疗。与非高脂血症性相比,高脂血症性胰腺炎患者的病情更加严重,但母婴预后无明显差异。结论:妊娠及产后合并急性胰腺炎的发病率与普通人群大致一致,主要由胆石症及高脂血症引起。高脂血症性胰腺炎的病情更为严重,但经过积极治疗仍可以有效改善患者预后。
