化脓性肝脓肿患者的治疗。
Treatment of patients with pyogenic liver abscess.
作者信息
Cerwenka H, Bacher H, Werkgartner G, El-Shabrawi A, Kornprat P, Bernhardt G A, Mischinger H J
机构信息
Department of Visceral Surgery, Medical University of Graz, Austria.
出版信息
Chemotherapy. 2005 Oct;51(6):366-9. doi: 10.1159/000088964. Epub 2005 Oct 14.
BACKGROUND
Pyogenic liver abscess (PLA) remains a serious disease with a mortality of 6-14%.
METHODS
Clinical data of 76 patients with PLA were analyzed. Treatment options comprised antibiotics, percutaneous puncture/drainage, endoscopic papillotomy/stenting and/or surgery as indicated.
RESULTS
Fifty-eight patients (76%) had single and 18 patients multiple PLA (right lobe: 65%; both lobes: 22%). The most frequent etiologies were: biliary (38%), hematogenous and posttraumatic (11%). Factors associated with the need for surgery included gallbladder empyema, biliary fistulas, malignancy, perforation, multicentricity, vascular complications and foreign bodies (e.g. infected ventriculo-peritoneal shunt, toothpick).
CONCLUSIONS
Microbiological testing provides important information for treatment monitoring and modification. Complementary assessment of risk factors for a complicated course is crucial for timely identification of patients requiring additional treatment.
背景
化脓性肝脓肿（PLA）仍然是一种严重疾病，死亡率为6%-14%。
方法
分析76例PLA患者的临床资料。治疗选择包括根据情况使用抗生素、经皮穿刺/引流、内镜乳头切开术/支架置入术和/或手术。
结果
58例（76%）患者为单发PLA，18例为多发PLA（右叶：65%；双叶：22%）。最常见的病因是：胆道（38%）、血源性和创伤后（11%）。与手术需求相关的因素包括胆囊积脓、胆瘘、恶性肿瘤、穿孔、多中心性、血管并发症和异物（如感染的脑室-腹腔分流管、牙签）。
结论
微生物检测为治疗监测和调整提供重要信息。对复杂病程的危险因素进行补充评估对于及时识别需要额外治疗的患者至关重要。
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