Hai A A, Singh A, Mittal V K, Karan G C
Department of Surgery, Patna Medical College Hospital, India.
Int Surg. 1991 Apr-Jun;76(2):81-3.
Two hundred and twenty cases of amoebic liver abscess were seen between 1981-1986. The majority were young or middle aged males belonging to the lower socio-economic group and 85% gave a history of drinking toddy (fermented palm juice). The highest incidence of the disease occurred during the peak toddy season (April to July). Toddy drinkers become susceptible perhaps because of the large dose of Entamoeba histolytica and bacteria ingested with the drink, associated malnutrition, poor hygiene, hepatic dysfunction and possible suppression of amoebistatic substance. Useful investigations consisted of skiagram and ultrasonography, the later being sometimes used to guide the aspiration needle to abscesses situated at unconventional sites. Over 88 per cent responded well to conservative treatment with aspiration(s). Laparotomy was required in slightly over 10% of cases and in these the mortality was 12% as compared to 2% with conservative treatment. Although a large amount of liver tissue appears to be destroyed, the residual liver damage is clinically, biochemically, macroscopically and microscopically minimal.
1981年至1986年间共发现220例阿米巴肝脓肿。大多数患者为年轻或中年男性，属于社会经济地位较低的群体，85%的患者有饮用棕榈酒（发酵的棕榈汁）的病史。该病的发病率在棕榈酒旺季（4月至7月）最高。饮用棕榈酒的人易患此病，可能是因为饮用时摄入了大量溶组织内阿米巴和细菌，同时伴有营养不良、卫生条件差、肝功能障碍以及可能的抗阿米巴物质抑制。有用的检查包括X线平片和超声检查，后者有时用于引导穿刺针进入位于非常规部位的脓肿。超过88%的患者经穿刺保守治疗后反应良好。略超过10%的病例需要进行剖腹手术，这些病例的死亡率为12%，而保守治疗的死亡率为2%。虽然大量肝组织似乎已被破坏，但残留的肝损伤在临床、生化、宏观和微观方面都很小。
