Comas Casanova P, Vargas Blasco V, Almirante Grágera B, González Fernández A, García Sureda D, Esteban Mur R, Guardia Massó J
Rev Clin Esp. 1989 Oct;185(5):225-9.
Thirty three cases of pyogenic liver abscess, (24 single and 9 multiple), diagnosed in our department during the past 6 years, were reviewed. Mean patient age was 54 years with a male predominance over females (1.5:1). The most frequently encountered underlying pathology was bile duct disease (33%), followed by previous liver disease (21%). Causal pathology could not be found in 4 cases (12%). The most frequent sign was fever (76%). Diagnosis was made by clinical picture and complementary exam (echography, CT scan and hepatic gammagraphy) in 29 cases (88%). Blood and pus cultures were positive in 47 and 67% of cases respectively. Thirty nine per cent of microbial abscesses were polymicrobial. E. coli and S. milleri were the most frequently isolated. No micro-organism were identified in 5 cases (15%). Antibiotic treatment was given to 33 patients. Surgical drainage was performed in 24 cases and percutaneous drainage in 7 patients. Two patients received antibiotics exclusively. Five patients died (15%), three of whom had a multiple abscess (33%) and the other two had a single abscess (8%). The efficacy of percutaneous drainage for diagnosis and treatment is analyzed reviewing recent literature.
回顾了过去6年中在我科诊断的33例化脓性肝脓肿病例（24例为单发，9例为多发）。患者平均年龄为54岁，男性多于女性（比例为1.5:1）。最常见的基础病变是胆管疾病（33%），其次是既往肝脏疾病（21%）。4例（12%）未发现病因。最常见的症状是发热（76%）。29例（88%）通过临床表现及辅助检查（超声、CT扫描和肝脏γ照相）确诊。血培养和脓液培养阳性率分别为47%和67%。39%的微生物性脓肿为多种微生物感染。大肠埃希菌和米勒链球菌是最常分离出的菌种。5例（15%）未鉴定出微生物。33例患者接受了抗生素治疗。24例行手术引流，7例行经皮引流。2例仅接受抗生素治疗。5例患者死亡（15%），其中3例为多发脓肿（33%），另外2例为单发脓肿（8%）。通过回顾近期文献分析经皮引流在诊断和治疗方面的疗效。
