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手术切开引流联合富血小板血浆治疗化脓性肝脓肿：1例报告

Treatment of pyogenic liver abscess by surgical incision and drainage combined with platelet-rich plasma: A case report.

作者信息

Wang Jun-Hong, Gao Zhen-Hua, Qian Hong-Liang, Li Jin-Shun, Ji Hao-Min, Da Ming-Xu

机构信息

The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China.

Department of Hepatobiliary Surgery, The First People's Hospital of Baiyin, Baiyin 730900, Gansu Province, China.

出版信息

World J Clin Cases. 2022 Jul 16;10(20):7082-7089. doi: 10.12998/wjcc.v10.i20.7082.

DOI:10.12998/wjcc.v10.i20.7082
PMID:36051112
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9297389/
Abstract

BACKGROUND

Pyogenic liver abscesses are insidious in the early stage. Some cases progress rapidly, and the patient's condition can worsen and even become life-threatening if timely treatment is not provided. Surgery and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the lumen.

CASE SUMMARY

We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment, review the literature related to the use of platelet-rich plasma (PRP) in the treatment of hepatic impairment and partial hepatectomy in animals, and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver abscesses. This is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans, providing new ideas for the treatment of this condition.

CONCLUSION

This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed medically. PRP may produce antimicrobial effects and promote the regeneration and repair of liver tissue.

摘要

背景

化脓性肝脓肿在早期较为隐匿。部分病例进展迅速，如果不及时治疗，患者病情会恶化甚至危及生命。如果脓肿较大且已液化并在腔内形成分隔，则通常需要手术及长期抗生素治疗。

病例摘要

我们报告1例经药物治疗效果不佳的细菌性肝脓肿病例，回顾动物中使用富血小板血浆（PRP）治疗肝损伤及部分肝切除术的相关文献，并探讨手术切开引流联合PRP治疗细菌性肝脓肿的预后特征。这是首例描述PRP用于治疗人类细菌性肝脓肿的病例，为该病的治疗提供了新思路。

结论

本病例突出了手术治疗对于液化良好但药物治疗效果不佳的细菌性肝脓肿的重要性。PRP可能具有抗菌作用并促进肝组织的再生和修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/6bbbe346679b/WJCC-10-7082-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/0df8fc53325c/WJCC-10-7082-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/777ffe9c5b46/WJCC-10-7082-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/99fc965fed89/WJCC-10-7082-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/746792678d3f/WJCC-10-7082-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/6bbbe346679b/WJCC-10-7082-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/0df8fc53325c/WJCC-10-7082-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/777ffe9c5b46/WJCC-10-7082-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/99fc965fed89/WJCC-10-7082-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/746792678d3f/WJCC-10-7082-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/febe/9297389/6bbbe346679b/WJCC-10-7082-g005.jpg

相似文献

1
Treatment of pyogenic liver abscess by surgical incision and drainage combined with platelet-rich plasma: A case report.手术切开引流联合富血小板血浆治疗化脓性肝脓肿：1例报告
World J Clin Cases. 2022 Jul 16;10(20):7082-7089. doi: 10.12998/wjcc.v10.i20.7082.
2
Acute Liver Failure Secondary to Pyogenic Hepatic Abscess.继发于化脓性肝脓肿的急性肝衰竭
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Optimal treatment of hepatic abscess.肝脓肿的最佳治疗方法。
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Management of pyogenic liver abscesses - percutaneous or open drainage?化脓性肝脓肿的治疗——经皮引流还是开放引流？
Singapore Med J. 2007 Dec;48(12):1158-65; quiz 1165.
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A prospective series case study of pyogenic liver abscess: recent trands in etiology and management.化脓性肝脓肿的前瞻性系列病例研究：病因及治疗的最新趋势
Indian J Surg. 2012 Oct;74(5):385-90. doi: 10.1007/s12262-011-0397-0. Epub 2012 Jan 7.
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Differentiation of pyogenic from amebic hepatic abscesses.化脓性肝脓肿与阿米巴肝脓肿的鉴别
Surg Gynecol Obstet. 1986 Feb;162(2):114-20.
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Surgical management of hepatic abscesses.肝脓肿的外科治疗
World J Surg. 1990 Jul-Aug;14(4):498-504. doi: 10.1007/BF01658675.
8
[Treatment of solitary pyogenic liver abscess (author's transl)].孤立性化脓性肝脓肿的治疗（作者译）
Dtsch Med Wochenschr. 1978 Jan 6;103(1):23-8. doi: 10.1055/s-0028-1104374.
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Pyogenic liver abscesses in patients with malignant disease: a report of 52 cases treated at a single institution.恶性疾病患者的化脓性肝脓肿：一家机构治疗的52例报告。
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Pyogenic liver abscess.化脓性肝脓肿
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May dexpanthenol, platelet-rich plasma, and thymoquinone provide new hope to maintain liver regeneration after partial hepatectomy?右泛醇、富血小板血浆和百里醌能否为肝部分切除术后维持肝脏再生带来新希望？
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富血小板血浆改善二甲基亚硝基脲诱导的肝纤维化的生化和分子机制
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Platelet-Rich Plasma May Offer a New Hope in Suppressed Wound Healing When Compared to Mesenchymal Stem Cells.与间充质干细胞相比，富血小板血浆可能为抑制的伤口愈合带来新希望。
J Clin Med. 2018 Jun 8;7(6):143. doi: 10.3390/jcm7060143.
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Platelet-rich plasma therapy and reproductive medicine.富血小板血浆治疗与生殖医学。
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A Klebsiella pneumoniae liver abscess presenting with myasthenia and tea-colored urine: A case report and review of 77 cases of bacterial rhabdomyolysis.一例伴有肌无力和茶色尿的肺炎克雷伯菌肝脓肿：病例报告及77例细菌性横纹肌溶解症的文献复习
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Functional assessment of autologous platelet-rich plasma (PRP) after long-term storage at -20 °C without any preservation agent.在无任何保存剂的情况下于-20°C长期储存后自体富血小板血浆（PRP）的功能评估。
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Platelet-rich plasma: from basic science to clinical applications.富含血小板的血浆：从基础科学到临床应用。
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Not every PRP-gel is born equal. Evaluation of growth factor availability for tissues through four PRP-gel preparations: Fibrinet, RegenPRP-Kit, Plateltex and one manual procedure.并非所有的富血小板血浆凝胶都是一样的。通过四种富血小板血浆凝胶制剂评估组织生长因子的可得性：Fibrinet、RegenPRP-Kit、Plateltex以及一种手工操作方法。
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