Clinical Features and Prognosis of Gas-Forming and Non-Gas-Forming Pyogenic Liver Abscess: A Comparative Study.
Clinical Features and Prognosis of Gas-Forming and Non-Gas-Forming Pyogenic Liver Abscess: A Comparative Study.
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气体形成和非气体形成化脓性肝脓肿的临床特征和预后：一项比较研究。
DOI：
10.21203/rs.2.24160/v1
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发表时间：
2020-02
期刊：
影响因子：
--
通讯作者：
Wu Rongqian
中科院分区：
文献类型：
--
作者：
Zhang Jia;Gao Yi;Du Zhaoqing;Ren Yifan;Bi Jianbin;Wu Zheng;Lv Yi;Wu Rongqian
背景：气体形成性化脓性肝脓肿 (GFPLA) 占所有化脓性肝脓肿 (PLA) 病例的 30%。然而，人们对 GFPLA 和非 GFPLA 之间临床特征和预后的差异知之甚少。目的：本回顾性研究比较了 GFPLA 和非 GFPLA 的临床特征和预后。患者和方法：回顾了2007年1月1日至2016年12月31日治疗的392例PLA患者的数据。形成气体的化脓性肝脓肿被定义为脓肿中的气体。肝脓肿被认为是非 GFPLA (n = 326) 或 GFPLA (n = 66)。将 GFPLA 患者的临床特征和结果与无 GFPLA 的患者进行比较。结果：各组在性别比例、年龄、吸烟、饮酒和合并症方面相似。肺炎克雷伯菌是最常见的致病菌，但非GFPLA组细菌培养阴性率高于GFPLA组。病因方面，GFPLA组胆道源感染较多，隐源性感染较少。此外，GFPLA组既往接受过肝胆手术，尤其是胆肠吻合术的比例较高。与非GFPLA组相比，GFPLA组抗生素联合经皮引流的比例较高，而单独抗生素药物和抗生素联合手术引流的比例较低。与非 GFPLA 患者相比，GFPLA 患者败血症和胸腔积液的发生率更高，住院时间也更长。无患者在住院期间死亡。结论：GFPLA组病原学上胆道源感染较多，隐源性感染较少。气体化脓性肝脓肿与既往肝胆手术，尤其是胆肠吻合术有关，脓毒症发生率高，住院时间长。因此，对于有肝胆手术史的PLA患者，应在PLA早期进行更密切的监测。它需要被视为一个独特的临床实体。
Background: Gas-forming pyogenic liver abscess (GFPLA) accounts for up to 30% of all pyogenic liver abscess (PLA) cases. However, little is known of the differences in clinical features and prognosis between GFPLA and non-GFPLA. Aim: This retrospective study compared the clinical features and prognosis of GFPLA and non-GFPLA. Patients and Methods: Data for 392 patients with PLA treated from January 1, 2007 to December 31, 2016 were reviewed. Gas-forming pyogenic liver abscess was defined as gas in the abscess. Liver abscesses were considered non-GFPLA (n = 326) or GFPLA (n = 66). The clinical features and outcomes of patients with GFPLA were compared with that of patients without GFPLA. Results: The groups were similar in gender ratio, age, smoking, drinking, and comorbidities. Klebsiella pneumoniae was the most common pathogenic bacteria, but the negative rate of bacterial culture of the non-GFPLA group was higher than that of the GFPLA. In etiologies, the GFPLA group had more biliary source infection and less cryptogenic infection. In addition, the GFPLA group had a higher rate of previous hepatobiliary surgery, especially biliary enteric anastomosis. Compared with the non-GFPLA group, the percentage of the GFPLA group with antibiotic agents combined with percutaneous drainage was higher, whereas the percentages given antibiotic agents alone and antibiotic agents combined with surgical drainage were lower. Patients with GFPLA had higher rates of sepsis and pleural effusion, and longer hospital stays than did non-GFPLA patients. No patient died during hospitalization. Conclusions: The GFPLA group had more biliary source infection and less cryptogenic infection in etiologies. Gas-forming pyogenic liver abscess is associated with past hepatobiliary surgery, especially biliary enteric anastomosis and has high rates of sepsis and long hospitalization. Thus, the patients with PLA with a history of hepatobiliary surgery should be monitored more closely in the early stage of the PLA. It needs to be recognized as a distinct clinical entity.
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DOI：
--
发表时间：
1993-11
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
C. Yang;Chiung Yu Chen;Xi-Zhang Lin;Ting-Tsung Chang;Jeng‐Shiann Shin;Ching‐Yih Lin
通讯作者：
C. Yang;Chiung Yu Chen;Xi-Zhang Lin;Ting-Tsung Chang;Jeng‐Shiann Shin;Ching‐Yih Lin
影响因子：
2.4
作者：
Kwon YK;Cheema FA;Maneckshana BT;Rochon C;Sheiner PA
通讯作者：
Sheiner PA
影响因子：
6.6
作者：
YANG, WH;SHEN, NC
通讯作者：
SHEN, NC
影响因子：
39.3
作者：
Johansen, Christine D.;Olsen, Rasmus H.;Sajadieh, Ahmad
通讯作者：
Sajadieh, Ahmad
影响因子：
9.8
作者：
Meddings, Liisa;Myers, Robert P.;Kaplan, Gilaad G.
通讯作者：
Kaplan, Gilaad G.