Sheen I S, Chien C S, Lin D Y, Liaw Y F
Liver Unit, Chang Gung Memorial Hospital, Taipei, Taiwan.
Am J Trop Med Hyg. 1989 Apr;40(4):384-9. doi: 10.4269/ajtmh.1989.40.384.
To examine the resolution of liver abscesses, a prospective ultrasonographic follow-up study was conducted in 51 patients, each with a solitary abscess (26 pyogenic and 25 amebic) which had been treated successfully by non-surgical measures. The rate of complete abscess resolution for each of the initial 6 months was 0%, 5%, 10%, 23%, 30%, and 30% in the amebic group; and 20%, 54%, 77%, 89%, 94%, and 94% in the pyogenic group. The absorption volume of the pyogenic group in the first month was also greater than that of the amebic group (3.0 +/- 5.0 ml/day vs. 1.1 +/- 0.8 ml/day, P less than 0.05). The resolution ratio of pyogenic and amebic liver abscesses in the first month was 74% +/- 38% and 36% +/- 23%, respectively. In 3 patients in the amebic group, the abscess was still detectable 2 years after treatment. These results suggest that pyogenic liver abscesses resolve more rapidly than amebic abscesses. These findings should be considered in the differential diagnosis of asymptomatic space-taking lesion in the liver.
为了研究肝脓肿的消散情况，我们对51例患者进行了一项前瞻性超声随访研究，这些患者均患有单个脓肿（26例为化脓性，25例为阿米巴性），且已通过非手术措施成功治疗。在最初的6个月中，阿米巴性肝脓肿组每个月的完全消散率分别为0%、5%、10%、23%、30%和30%；化脓性肝脓肿组分别为20%、54%、77%、89%、94%和94%。化脓性肝脓肿组第一个月的吸收量也大于阿米巴性肝脓肿组（3.0±5.0 ml/天对1.1±0.8 ml/天，P<0.05）。化脓性和阿米巴性肝脓肿第一个月的消散率分别为74%±38%和36%±23%。在阿米巴性肝脓肿组的3例患者中，治疗2年后仍可检测到脓肿。这些结果表明，化脓性肝脓肿比阿米巴性肝脓肿消散得更快。在对肝脏无症状占位性病变进行鉴别诊断时应考虑这些发现。
