Clinical Charateristics and Outcome of Pyogenic Liver Abscess with Different Size: 15-Year Experience from a Single Center.
Clinical Charateristics and Outcome of Pyogenic Liver Abscess with Different Size: 15-Year Experience from a Single Center.
复制标题
不同大小化脓性肝脓肿的临床特征和转归：单中心 15 年经验
DOI：
10.1038/srep35890
复制
发表时间：
2016-10-24
影响因子：
4.6
通讯作者：
Zhang XF
中科院分区：
文献类型：
--
作者：
Du ZQ;Zhang LN;Lu Q;Ren YF;Lv Y;Liu XM;Zhang XF
化脓性肝脓肿（PLA）的标准治疗方案尚未建立。我们调查了不同大小的PLA的临床特征、疾病进展、治疗方法的选择和结局。回顾性纳入2000年至2014年410例PLA患者，分为小脓肿（≤5 cm，n = 125）、大脓肿（5 cm至10 cm，n = 218）和巨大脓肿（>10 cm，n = 36）。脓液培养以肺炎克雷伯菌（22%）和大肠埃希菌（11%）最常见，血培养以大肠埃希菌（36.7%）、革兰阳性球菌（36.7%）和肺炎克雷伯菌（33.3%）最常见。单纯抗生素治疗115例（28.0%），经皮穿刺引流（PD）161例（39.3%），手术切开引流（SD）134例（32.7%）。脓肿大小与白细胞升高、白蛋白降低和体温恢复正常时间相关（均P < 0.05）。单纯抗生素治疗、PD和SD主要用于小脓肿（42.4%）、大脓肿（44.0%）和巨大脓肿（47.2%）。对于巨大脓肿患者，SD组（n = 17）的发病率高于PD组（n = 14）（76.4% vs. 35.7%，p = 0.022）。腹膜透析治疗巨大脓肿的治愈率与腹膜透析相当，但具有创伤小、并发症少、住院时间短等优点。
The standard therapeutic protocols of pyogenic liver abscess (PLA) have not been well established yet. We investigated the clinical characteristics, disease progression, choices of treatments and outcomes of PLA with different size. 410 cases of patients with PLA were enrolled retrospectively from 2000 to 2014, and were grouped as small abscess (≤5 cm, n = 125), large abscess (5 cm to 10 cm, n = 218) and giant abscess (>10 cm, n = 36). The most common bacteria were Klebsiella pneumonia (22%) and Escherichia coli (11%) by pus culture, and Escherichia coli (36.7%), gram-positive coccus,(36.7%) and Klebsiella pneumonia (33.3%) by blood culture. 115 patients (28.0%) received antibiotics treatment alone, 161 patients (39.3%) received percutaneous drainage (PD) and 134 patients (32.7%) underwent surgical incision and drainage (SD). The size of abscess was correlated with leukocytes increase, albumin decrease, and time duration for body temperature normalization (all p < 0.05). Antibiotics treatment alone, PD and SD was mainly used in patients with small abscess (42.4%), large abscess (44.0%) and giant abscess (47.2%), respectively. For patients with giant abscess, SD group (n = 17) had higher morbidity than PD group (n = 14) (76.4% vs. 35.7%, p = 0.022). PD might achieve the same curative rate as SD in giant abscess, but with less trauma, lower morbidity and shorter hospital stay.
登录
查看更多内容
DOI：
10.1155/2012/316013
发表时间：
2012
期刊：
HPB surgery : a world journal of hepatic, pancreatic and biliary surgery
影响因子：
--
作者：
Alkofer B;Dufay C;Parienti JJ;Lepennec V;Dargere S;Chiche L
通讯作者：
Chiche L
影响因子：
19.7
作者：
Hui, Joyce Y. H.;Yang, Michael K. W.;Woo, Patrick C. Y.
通讯作者：
Woo, Patrick C. Y.
影响因子：
9.8
作者：
Meddings, Liisa;Myers, Robert P.;Kaplan, Gilaad G.
通讯作者：
Kaplan, Gilaad G.
影响因子：
4.3
作者：
Pang, Tony C. Y.;Fung, Thomas;Smith, Ross C.
通讯作者：
Smith, Ross C.
影响因子：
2.6
作者：
Shelat, Vishal G.;Chia, Clement L. K.;Junnarkar, Sameer P.
通讯作者：
Junnarkar, Sameer P.