Muñoz L E, Botello M A, Carrillo O, Martínez A M
Gastroenterology Service, School of Medicine, University of Nuevo León, Monterrey, México.
Arch Med Res. 1992;23(2):251-3.
A retrospective analysis of 140 cases with amebic liver abscess (ALA) seen at the AUNL University Hospital was done to see if patients with complications can be identified earlier in order to decrease morbidity and mortality. Sixteen patients (11.4%) presented complications and six patients died (4.2%). Patients with complications presented jaundice, large or multiple abscesses, acute abdomen, liver failure and sepsis more often than patients without complications. Hemoglobin, hematocrit, prothrombin time, total proteins, albumin, LDH, and BUN were more altered in patients who presented complications. The titer of antibodies against E. histolytica was higher in this group of patients. The six patients who died had been operated on. The causes of death were septic shock in two, sepsis in one, peritonitis in one, liver failure in one and colon perforation in one patient. Pleural effusion, jaundice and acute abdomen were seen in three patients, respectively (50%), two cases had multiple abscesses (33.3%), one patient had a ruptured abscess (16.7%). Patients who died exhibited more alterations in six laboratory examinations at admission: partial prothrombin time, total bilirubin, albumin, BUN, LDH, and leukocytes. Clinical data together with the severe alterations in laboratory examinations at admission for patients with ALA should alert the clinician to suspect complications earlier in order to decrease morbidity and mortality.
对奥贡州大学医院收治的140例阿米巴肝脓肿（ALA）患者进行回顾性分析，以确定是否能更早识别出有并发症的患者，从而降低发病率和死亡率。16例患者（11.4%）出现并发症，6例患者死亡（4.2%）。有并发症的患者比无并发症的患者更常出现黄疸、脓肿大或多发、急腹症、肝衰竭和脓毒症。出现并发症的患者血红蛋白、血细胞比容、凝血酶原时间、总蛋白、白蛋白、乳酸脱氢酶和尿素氮的变化更大。该组患者抗溶组织内阿米巴抗体滴度更高。死亡的6例患者均接受了手术。死亡原因分别为：2例感染性休克、1例脓毒症、1例腹膜炎、1例肝衰竭和1例结肠穿孔。分别有3例患者出现胸腔积液、黄疸和急腹症（50%），2例有多发脓肿（33.3%），1例脓肿破裂（16.7%）。死亡患者入院时六项实验室检查的变化更大：部分凝血酶原时间、总胆红素、白蛋白、尿素氮、乳酸脱氢酶和白细胞。临床数据以及ALA患者入院时实验室检查的严重变化应提醒临床医生更早怀疑并发症，以降低发病率和死亡率。
