Barrio J, Cosme A, Ojeda E, Garmendia G, Castiella A, Bujanda L, Fernández J, Arenas J I
Servicio de Digestivo, Hospital Aránzazu, San Sebastián, Guipúzcoa, 20071, España.
Rev Esp Enferm Dig. 2000 Apr;92(4):232-9.
to determine the clinical, microbiological, diagnostic and therapeutic characteristics of pyogenic liver abscesses of bacterial origin.
retrospective analysis of pyogenic liver abscesses diagnosed at the Aránzazu Hospital in San Sebastián (northern Spain) between 1989 and 1998.
we studied 45 patients with pyogenic liver abscesses of bacterial origin (30 men, 15 women, mean age 61 years 11 months). The site of the liver abscess was biliary in 28.9% of the patients, portal in 11.1%, and unknown in 33.3%. Elevated erythrocyte sedimentation rate (95.5%), leukocytosis (86.7%) and fever (82.2%) were the most frequent clinical and laboratory findings. The abscesses were solitary in 55. 5% of the patients. Echography was diagnostic in 68.4% of patients, and computed tomography was diagnostic in 100%. Cultures of pus from the abscess and blood were positive in 77.1% and 50% respectively. Of the abscesses diagnosed as being of bacterial origin, 44.4% involved multiple organisms. Escherichia coli and Streptococcus milleri were the germs isolated most frequently. Percutaneous drainage was done in 22 patients (48.9%), with satisfactory results in 18. Overall mortality related with abscesses was 15.5%.
the clinical presentation of pyogenic liver abscess did not vary during the study period. Computed tomography is fundamental for diagnosis and treatment. Percutaneous drainage associated with early antibiotic therapy is the treatment of choice.
确定细菌性肝脓肿的临床、微生物学、诊断及治疗特点。
回顾性分析1989年至1998年在西班牙北部圣塞瓦斯蒂安的阿兰萨祖医院诊断的细菌性肝脓肿病例。
我们研究了45例细菌性肝脓肿患者（男性30例，女性15例，平均年龄61岁11个月）。肝脓肿的来源中，28.9%为胆源性，11.1%为门静脉源性，33.3%来源不明。红细胞沉降率升高（95.5%）、白细胞增多（86.7%）和发热（82.2%）是最常见的临床和实验室表现。55.5%的患者脓肿为单发。68.4%的患者通过超声检查确诊，100%的患者通过计算机断层扫描确诊。脓肿脓液培养和血培养阳性率分别为77.1%和50%。在诊断为细菌性的脓肿中，44.4%涉及多种微生物。大肠埃希菌和米勒链球菌是最常分离出的病菌。22例患者（48.9%）接受了经皮引流，18例效果满意。与脓肿相关的总体死亡率为15.5%。
在研究期间，细菌性肝脓肿的临床表现无变化。计算机断层扫描对诊断和治疗至关重要。经皮引流联合早期抗生素治疗是首选治疗方法。
