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成人肝脓肿:居住在台湾东北部农村地区患者的特征。

Adult liver abscess: characteristics of patients living in rural north-eastern Taiwan.

机构信息

Division of Family Medicine, I-Lan Hospital, I-Lan, Taiwan.

出版信息

Int J Clin Pract. 2009 Jun;63(6):949-53. doi: 10.1111/j.1742-1241.2007.01285.x. Epub 2007 May 30.

DOI:10.1111/j.1742-1241.2007.01285.x
PMID:17537193
Abstract

AIMS

This study aimed to analyse the characteristics of adult liver abscess (LA) patients living in rural townships of Taiwan.

PATIENTS AND METHODS

We retrospectively screened the electronic admission records of a rural community hospital located in north-eastern Taiwan from 1 April, 2002 to 30 April, 2006. Relevant data, including subjects' basic characteristics, laboratory findings and infectious microorganisms, were extracted.

RESULTS

Fifty-six subjects (mean age: 66.1 +/- 15.9 years; range: 23-94 years) were enrolled; one patient had an amoebic LA and 55 had pyogenic LA. Five subjects died in hospital. Overall, 80.5% of patients complained of having a fever, 87.5% had single abscess, 71.4% had right hepatic lobe involvement and 58.9% underwent invasive drainage. Most subjects (66.1%) did not have diabetes mellitus, 94.6% did not have a hepato-biliary tumour, 73.2% did not have gallstones, 78.6% did not have hepatitis and 87.5% did not have prior hepato-biliary surgery. Klebsiella pneumoniae was the most common infecting microorganism. Previous hepato-biliary surgery and serum creatinine >2.0 mg/dl were significantly more common in patients >or=65 years of age (p = 0.031). Diabetes mellitus was more common in female subjects (p = 0.021). Invasive drainage and single abscess were not significantly correlated to prognosis.

DISCUSSION

Adult LA patients living in rural north-eastern Taiwan have different characteristics than patients living in urban areas. Geriatric LA patients should be managed cautiously because of the possibility of renal insufficiency or previous hepato-biliary surgery. Female LA patients should be evaluated for the presence of diabetes mellitus.

摘要

目的

本研究旨在分析居住在台湾农村乡镇的成人肝脓肿(LA)患者的特征。

方法

我们回顾性筛选了 2002 年 4 月 1 日至 2006 年 4 月 30 日位于台湾东北部的一家农村社区医院的电子入院记录。提取了相关数据,包括患者的基本特征、实验室检查结果和感染微生物。

结果

共纳入 56 例患者(平均年龄:66.1±15.9 岁;范围:23-94 岁);1 例为阿米巴性 LA,55 例为化脓性 LA。5 例患者在院死亡。总体而言,80.5%的患者有发热症状,87.5%有单个脓肿,71.4%有右肝叶受累,58.9%行侵入性引流。大多数患者(66.1%)无糖尿病,94.6%无肝胆肿瘤,73.2%无胆结石,78.6%无肝炎,87.5%无既往肝胆手术史。最常见的感染微生物是肺炎克雷伯菌。>65 岁的患者中,既往肝胆手术和血清肌酐>2.0mg/dl 更为常见(p=0.031)。女性患者中糖尿病更为常见(p=0.021)。侵入性引流和单个脓肿与预后无显著相关性。

讨论

居住在台湾东北部农村的成人 LA 患者与居住在城市的患者具有不同的特征。由于存在肾功能不全或既往肝胆手术的可能性,老年 LA 患者应谨慎处理。应评估女性 LA 患者是否存在糖尿病。

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