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学科主题: 感染疾病科
题名:
肝脓肿患者肝脏损害特点的回顾性分析
其他题名: Hepatic injury characteristics of liver abscess
作者: 李俊; 赵鸿
关键词: 肝脓肿 ; 回顾性研究 ; Liver abscess ; Retrospective studies
刊名: 中华实验和临床病毒学杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1003-9279.2012.03.013
卷: 26, 期:3, 页:202-204
收录类别: 中国科技核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 分析肝脓肿患者肝脏损害的临床特点、病原学、诊断和治疗.方法 回顾性分析1995年1月至2011年12月北京大学第一医院住院治疗的181例成人肝脓肿患者的人口学资料和临床资料.结果 患者中位年龄60(19 ~82)岁,其中有基础病患者139例(76.8%).68例(37.6%)患者入院时考虑肝脓肿的诊断.常见症状有发热(92.8%),出现肝区压痛、叩击痛者仅43%,肝脏功能检查中以低白蛋白血症(72.4%)和谷氨酰转肽酶升高(79.8%)为主、仅44.3%患者同时有丙氨酸转氨酶升高.脓肿以右叶(63%)、单发(74%)为主,直径多为5 ~ 10 cm.67例(37%)隐源性感染患者中,55.2%有糖尿病基础.血培养24例阳性,脓液培养79例阳性,肺炎克雷白菌56例(60.2%),大肠埃希菌21例(22.6%).113例(62.4%)患者,经超声/CT引导下经皮穿刺抽液和(或)置管引流治疗.结论 不足半数肝脓肿患者伴有右上腹阳性症状和体征.实验室检查以低白蛋白血症、谷氨酰转肽酶升高为主.脓肿多累及肝脏右叶、且多为单个.菌种以肺炎克雷白菌和大肠埃希菌为主.临床上需对于没有腹部表现的发热患者(尤其是已有糖尿病基础者),在必要时行影像学检查,以免漏诊、误诊肝脓肿. Objective To analyse the clinical characteristics of hepatic injury of liver abscess.Methods Demographics and clinical data of 181adult cases of liver abscesses admitted to a tertiary hospital over 16 years( 1995-2011) were retrospectively reviewed.Results Median age was 60 (19-82) years.139 patients(76.8% ) had underlying diseases.The most common chief complaint was fever( 92.8% ).The most common physical finding was right-upper-quadrant tenderness (43%). Hypoalbuminemia was in 72.4% cases.79.8% cases had an elevated γGT.74% patients had a single liver abscess,63% being in the right lobe.67 patients were cryptogenic,among those 55.2% cases wers diabetes mellitus.113 patients ( 62.4% ) were treated by percutaneous drainage with antibiotic therapy.Conclusion Patients with positive right-upper-quadrant symptoms and signs were less than a half.Deranged LFTs were Hypoalbuminemia and elevated γGT.Liver abscesses were mainly located in the right lobe and single.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/41693
Appears in Collections:北京大学第一临床医学院_感染疾病科_期刊论文

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作者单位: 100034,北京大学第一医院感染疾病科
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