肝脓肿早期吸入的预测因素。
Predictive factors for early aspiration in liver abscess.
作者信息
Khan Rustam, Hamid Saeed, Abid Shahab, Jafri Wasim, Abbas Zaigham, Islam Mohammed, Shah Hasnain, Beg Shaalan
机构信息
Department of Medicine, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
出版信息
World J Gastroenterol. 2008 Apr 7;14(13):2089-93. doi: 10.3748/wjg.14.2089.
AIM
To determine the predictive factors for early aspiration in liver abscess.
METHODS
A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.
RESULTS
A total of 966 patients, 738 (76%) male, mean age 43 +/- 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age > or = 55 years, size of abscess > or = 5 cm, involvement of both lobes of the liver and duration of symptoms > or = 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group.
CONCLUSION
Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.
目的
确定肝脓肿早期穿刺引流的预测因素。
方法
对1995年至2004年所有肝脓肿患者进行回顾性分析。661例（68%）患者的脓肿诊断为阿米巴性，200例（21%）为化脓性，73例（8%）为不明原因，32例（3%）为混合性。采用多因素logistic回归分析确定肝脓肿穿刺引流的预测因素。
结果
共评估966例患者，其中男性738例（76%），平均年龄43±17岁。540例患者接受药物治疗，426例患者接受经皮穿刺引流辅助治疗。肝脓肿穿刺引流的预测因素为：年龄≥55岁、脓肿大小≥5 cm、肝两叶受累及症状持续时间≥7天。穿刺引流组的住院时间比非穿刺引流组相对较长。穿刺引流组有12例患者死亡，与非穿刺引流组相比，该死亡率无统计学意义。
结论
无论病因如何，高龄、脓肿大小>5 cm、肝两叶受累及症状持续时间>7天的患者可能需要进行肝脓肿穿刺引流。
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