Lee Tae Hee, Park Joo Ho, Kim Sung Tae, Jung Jang Han, Kim Yong Seok, Kim Sun Moon, Im Euyi Hyeog, Huh Kyu Chan, Choi Young Woo, Kang Young Woo
Department of Internal Medicine, College of Medicine, Konyang University, Daejeon, Korea.
Korean J Gastroenterol. 2010 Aug;56(2):90-6.
BACKGROUND/AIMS: Pyogenic liver abscess remains a major diagnostic and therapeutic challenge, despite advances in diagnostic technology and new strategies for treatment. This study was conducted to compare the differences in clinical features and outcomes of pyogenic liver abscess according to age.
In total, 166 patients were enrolled and included 63 (<65 years old, group I), 62 (65-74 years old, group II), 41 (>75 years old, group III) patients in each group. We reviewed the medical records retrospectively including etiology, underlying diseases, characteristics of the liver abscess, laboratory and microbiologic findings, treatment, and outcome of the patients.
Group I had higher prevalence rates of male patients and chronic alcoholics, but lower prevalence rates of biliary disease, hypertension, and malignancy. In laboratory findings, group II had higher incidence of thrombocytopenia, elevated blood urea nitrogen and creatinine. There were no differences in symptoms and microbiologic findings in blood and pus among the three groups. Liver abscesses were more common in right liver in Group I. The lengths of stay and the treatment modalities were similar in three groups.
Although there were differences in sex ratio, etiology, underlying disease among the different age groups, they did not cause difference in treatment and clinical outcome of pyogenic liver abscess. Thus, we recommend active treatments in patients of all age.
背景/目的：尽管诊断技术取得了进步，且出现了新的治疗策略，但化脓性肝脓肿仍然是一个主要的诊断和治疗挑战。本研究旨在比较不同年龄组化脓性肝脓肿的临床特征和预后差异。
总共纳入166例患者，每组分别有63例（<65岁，I组）、62例（65 - 74岁，II组）、41例（>75岁，III组）。我们回顾性分析了病历，包括病因、基础疾病、肝脓肿特征、实验室和微生物学检查结果、治疗方法及患者预后。
I组男性患者和慢性酒精中毒者的患病率较高，但胆道疾病、高血压和恶性肿瘤的患病率较低。在实验室检查结果中，II组血小板减少症、血尿素氮和肌酐升高的发生率较高。三组在症状以及血液和脓液的微生物学检查结果方面没有差异。I组肝脓肿在右肝更为常见。三组的住院时间和治疗方式相似。
尽管不同年龄组在性别比例、病因、基础疾病方面存在差异，但这些差异并未导致化脓性肝脓肿在治疗和临床预后上出现不同。因此，我们建议对所有年龄段的患者都进行积极治疗。
