细菌性肝脓肿合并糖尿病48例
姜海琼,王兴鹏,上海市第一人民医院消化内科 上海市 200080
通讯作者:姜海琼,200080, 上海市武进路85号,上海市第一人民医院消化内科. jianghaiqiong@medmail.com.cn
电话: 021-63240090-3141
收稿日期:2005-03-07 接受日期:2005-04-13
摘要目的:分析细菌性肝脓肿合并糖尿病的病因、临床特点、诊治及转归.
, http://www.100md.com 方法:采用回顾性调查，分析我院确诊的48例细菌性肝脓肿合并糖尿病的病因、所伴随的基础疾病、临床特征、诊治及转归.
结果:细菌性肝脓肿合并糖尿病多见于男性，以右叶(70.8%)及多发(75.0%)为最常见，临床表现并不典型，所有病例均运用有效抗生素控制炎症及用胰岛素控制血糖，本组19例(39.6%)及时行B超或CT引导下的穿刺抽脓或置管引流.本组2例(4.2%)死因为感染及多脏器功能衰竭.
结论:细菌性肝脓肿合并糖尿病的临床表现并不典型，诊断较为困难，对糖尿病伴发热者应高度重视，控制血糖，及时治疗胆系感染是预防本病发生的重要措施.
姜海琼,王兴鹏. 细菌性肝脓肿合并糖尿病48例.世界华人消化杂志 2005;13(12):1469-1471
, 百拇医药
Chou FF, Sheen-Chen SM, Chen YS, Chen MC. Singleand multiple pyogenic liver abscesses: clinical course, etiology,and results of treatment. World J Surg 1997;21:384-388
2 Yang CC, Chen CY, Lin XZ, Chang TT, Shin JS, Lin CY. Pyogenic liverabscess in Taiwan: emphasis on gas-forming
liver abscess in diabetics. Am JGastroenterol 1993;88:1911-1915
3 梁扩寰. 肝脏病学. 第2版. 北京:人民卫生出版社, 1995:830-831
, 百拇医药
4 Liew KV, Lau TC, Ho CH, Cheng TK, Ong YS, Chia SC, Tan CC. Pyogenicliver abscess--a tropical centre's experience
in management with review of currentliterature. Singapore Med J 2000;41:489-492
5 Saad F, Ach K, Dallel Youssef N, Maarouf A, Chaieb Chadli M, ChaiebL. Hepatic abscess in diabetics, 2 case reports.
Presse Med 2004;33:98-100
6 Cheng DL, Liu YC, Yen MY, Liu CY, Wang RS. Septic metastaticlesions of pyogenic liver abscess. Their association
, 百拇医药
with Klebsiella pneumoniae bacteremia indiabetic patients. Arch Intern Med 1991;151:1557-1559
7 Huang CJ, Pitt HA, Lipsett PA, Osterman FA Jr, Lillemoe KD, CameronJL, Zuidema GD. Pyogenic hepatic abscess.
Changing trends over 42 years. Ann Surg 1996;223:600-607
8 Shimada H, Ohta S, Maehara M, Katayama K, Note M, Nakagawara G.Diagnostic and therapeutic strategies of
, 百拇医药
pyogenic liver abscess. Int Surg 1993;78:40-45
9 Chou FF, Sheen-Chen SM, Chen YS, Lee TY. The comparison of clinicalcourse and results of treatment between
gas-forming and non-gas-forming pyogenicliver abscess. Arch Surg 1995;130:401-405
10 Chu KM, Fan ST, Lai EC, Lo CM, Wong J. Pyogenic liver abscess. Anaudit of experience over the past decade.
Arch Surg 1996;131:148-152
, 百拇医药
11 Serste T, Ducobu J, Bouton F, Van Laethem A. Klebsiella and E. coliliver abscess associated with aerobilia:
a case report. Acta Clin Belg 2004;59:165-167
12 Tapia A, Llanos O, Sharp A, Velasco A, Guzman S, Ibanez L. Pyogenicliver abscess. Experience with 50 cases.
Rev Med Chil 1994;122:907-912
13 Corbella X, Vadillo M, Torras J, Pujol M, Rafecas A, Gudiol F.Presentation, diagnosis and treatment of pyogenic
, http://www.100md.com
liver abscess: analysis of a seriesof 63 cases. Enferm Infecc Microbiol Clin 1995;13:80-84
14 Lee KT, Wong SR, Sheen PC. Pyogenic liver abscess: an audit of 10years' experience and analysis of risk factors.
Dig Surg 2001;18:459-465
15 Barrio J, Cosme A, Ojeda E, Garmendia G, Castiella A, Bujanda L,Fernandez J, Arenas JI. Pyogenic liver abscesses
of bacterial origin. A study of 45cases. Rev Esp Enferm Dig 2000;92:232-239
, http://www.100md.com
16 Wong WM, Wong BC, Hui CK, Ng M, Lai KC, Tso WK, Lam SK, Lai CL.Pyogenic liver abscess: retrospective analysis of
80 cases over a 10-year period. JGastroenterol Hepatol 2002;17:1001-1007
17 Okano H, Shiraki K, Inoue H, Kawakita T, Yamamoto N, Deguchi M,Sugimoto K, Sakai T, Ohmori S, Murata K,Nakano T. Clinicopathologicalanalysis of liver abscess in Japan. Int J Mol Med 2002;10:627-630
, 百拇医药 18 Benazzouz M, Afifi R, Ibrahimi A, Essaid FA, Sebti MF. Liverabscess: diagnosis and treatment. Study of a series
of 22 cases. Ann GastroenterolHepatol (Paris) 1996;31:333-336
19 Tapia A, Llanos O, Sharp A, Velasco A, Guzman S, Ibanez L. Pyogenicliver abscess. Experience with 50 cases.
Rev Med Chil 1994;122:907-912
20 Barakate MS, Stephen MS, Waugh RC, Gallagher PJ, Solomon MJ, StoreyDW, Sheldon DM. Pyogenic liver abscess:
a review of 10 years' experience inmanagement. Aust N Z J Surg 1999;69:205-209
编辑 张海宁, http://www.100md.com( 姜海琼, 王兴鹏)
通讯作者:姜海琼,200080, 上海市武进路85号,上海市第一人民医院消化内科. jianghaiqiong@medmail.com.cn
电话: 021-63240090-3141
收稿日期:2005-03-07 接受日期:2005-04-13
摘要目的:分析细菌性肝脓肿合并糖尿病的病因、临床特点、诊治及转归.
, http://www.100md.com 方法:采用回顾性调查，分析我院确诊的48例细菌性肝脓肿合并糖尿病的病因、所伴随的基础疾病、临床特征、诊治及转归.
结果:细菌性肝脓肿合并糖尿病多见于男性，以右叶(70.8%)及多发(75.0%)为最常见，临床表现并不典型，所有病例均运用有效抗生素控制炎症及用胰岛素控制血糖，本组19例(39.6%)及时行B超或CT引导下的穿刺抽脓或置管引流.本组2例(4.2%)死因为感染及多脏器功能衰竭.
结论:细菌性肝脓肿合并糖尿病的临床表现并不典型，诊断较为困难，对糖尿病伴发热者应高度重视，控制血糖，及时治疗胆系感染是预防本病发生的重要措施.
姜海琼,王兴鹏. 细菌性肝脓肿合并糖尿病48例.世界华人消化杂志 2005;13(12):1469-1471
, 百拇医药
Chou FF, Sheen-Chen SM, Chen YS, Chen MC. Singleand multiple pyogenic liver abscesses: clinical course, etiology,and results of treatment. World J Surg 1997;21:384-388
2 Yang CC, Chen CY, Lin XZ, Chang TT, Shin JS, Lin CY. Pyogenic liverabscess in Taiwan: emphasis on gas-forming
liver abscess in diabetics. Am JGastroenterol 1993;88:1911-1915
3 梁扩寰. 肝脏病学. 第2版. 北京:人民卫生出版社, 1995:830-831
, 百拇医药
4 Liew KV, Lau TC, Ho CH, Cheng TK, Ong YS, Chia SC, Tan CC. Pyogenicliver abscess--a tropical centre's experience
in management with review of currentliterature. Singapore Med J 2000;41:489-492
5 Saad F, Ach K, Dallel Youssef N, Maarouf A, Chaieb Chadli M, ChaiebL. Hepatic abscess in diabetics, 2 case reports.
Presse Med 2004;33:98-100
6 Cheng DL, Liu YC, Yen MY, Liu CY, Wang RS. Septic metastaticlesions of pyogenic liver abscess. Their association
, 百拇医药
with Klebsiella pneumoniae bacteremia indiabetic patients. Arch Intern Med 1991;151:1557-1559
7 Huang CJ, Pitt HA, Lipsett PA, Osterman FA Jr, Lillemoe KD, CameronJL, Zuidema GD. Pyogenic hepatic abscess.
Changing trends over 42 years. Ann Surg 1996;223:600-607
8 Shimada H, Ohta S, Maehara M, Katayama K, Note M, Nakagawara G.Diagnostic and therapeutic strategies of
, 百拇医药
pyogenic liver abscess. Int Surg 1993;78:40-45
9 Chou FF, Sheen-Chen SM, Chen YS, Lee TY. The comparison of clinicalcourse and results of treatment between
gas-forming and non-gas-forming pyogenicliver abscess. Arch Surg 1995;130:401-405
10 Chu KM, Fan ST, Lai EC, Lo CM, Wong J. Pyogenic liver abscess. Anaudit of experience over the past decade.
Arch Surg 1996;131:148-152
, 百拇医药
11 Serste T, Ducobu J, Bouton F, Van Laethem A. Klebsiella and E. coliliver abscess associated with aerobilia:
a case report. Acta Clin Belg 2004;59:165-167
12 Tapia A, Llanos O, Sharp A, Velasco A, Guzman S, Ibanez L. Pyogenicliver abscess. Experience with 50 cases.
Rev Med Chil 1994;122:907-912
13 Corbella X, Vadillo M, Torras J, Pujol M, Rafecas A, Gudiol F.Presentation, diagnosis and treatment of pyogenic
, http://www.100md.com
liver abscess: analysis of a seriesof 63 cases. Enferm Infecc Microbiol Clin 1995;13:80-84
14 Lee KT, Wong SR, Sheen PC. Pyogenic liver abscess: an audit of 10years' experience and analysis of risk factors.
Dig Surg 2001;18:459-465
15 Barrio J, Cosme A, Ojeda E, Garmendia G, Castiella A, Bujanda L,Fernandez J, Arenas JI. Pyogenic liver abscesses
of bacterial origin. A study of 45cases. Rev Esp Enferm Dig 2000;92:232-239
, http://www.100md.com
16 Wong WM, Wong BC, Hui CK, Ng M, Lai KC, Tso WK, Lam SK, Lai CL.Pyogenic liver abscess: retrospective analysis of
80 cases over a 10-year period. JGastroenterol Hepatol 2002;17:1001-1007
17 Okano H, Shiraki K, Inoue H, Kawakita T, Yamamoto N, Deguchi M,Sugimoto K, Sakai T, Ohmori S, Murata K,Nakano T. Clinicopathologicalanalysis of liver abscess in Japan. Int J Mol Med 2002;10:627-630
, 百拇医药 18 Benazzouz M, Afifi R, Ibrahimi A, Essaid FA, Sebti MF. Liverabscess: diagnosis and treatment. Study of a series
of 22 cases. Ann GastroenterolHepatol (Paris) 1996;31:333-336
19 Tapia A, Llanos O, Sharp A, Velasco A, Guzman S, Ibanez L. Pyogenicliver abscess. Experience with 50 cases.
Rev Med Chil 1994;122:907-912
20 Barakate MS, Stephen MS, Waugh RC, Gallagher PJ, Solomon MJ, StoreyDW, Sheldon DM. Pyogenic liver abscess:
a review of 10 years' experience inmanagement. Aust N Z J Surg 1999;69:205-209
编辑 张海宁, http://www.100md.com( 姜海琼, 王兴鹏)
