前瞻性观察研究泰国东北部类鼻疽患者腹腔脓肿的频率和特征。
Prospective observational study of the frequency and features of intra-abdominal abscesses in patients with melioidosis in northeast Thailand.
机构信息
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Rajthevi, Bangkok, Thailand.
出版信息
Trans R Soc Trop Med Hyg. 2012 Oct;106(10):629-31. doi: 10.1016/j.trstmh.2012.05.007. Epub 2012 Jul 7.
Retrospective case series from Thailand have reported the presence of intra-abdominal abscesses in around half of patients with melioidosis, a much higher rate than our clinical experience would suggest. We performed a prospective, observational study of 230 adult patients with culture-confirmed melioidosis in which all patients underwent abdominal ultrasound. One or more abscesses were detected in the liver and/or spleen in 77 (33%) cases. These were often multiple (70%, 31/44 in hepatic abscesses and 88%, 50/57 in splenic abscesses) and clinically silent (27% of cases with abscesses presenting with abdominal pain). The mortality rate at 4 weeks post-discharge was lower in patients who were abscess-positive vs abscess-negative (10%, 8/77 vs 20%, 31/153).
泰国的回顾性病例系列研究报告称，约一半的类鼻疽病患者存在腹腔脓肿，这一比例远高于我们的临床经验提示的水平。我们对 230 例经培养证实的类鼻疽成年患者进行了前瞻性观察性研究，所有患者均接受了腹部超声检查。在 77 例（33%）患者中发现肝脏和/或脾脏存在一个或多个脓肿。这些脓肿往往是多发性的（肝脓肿中为 70%，31/44；脾脓肿中为 88%，50/57），且临床上无明显症状（有脓肿的患者中，27%表现为腹痛）。出院后 4 周时，脓肿阳性患者的死亡率低于脓肿阴性患者（10%，8/77 与 20%，31/153）。
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