Mehta R B, Parija S C, Chetty D V, Smile R R
Int Surg. 1986 Apr-Jun;71(2):91-4.
The clinical features and surgical management of 240 cases of liver abscess admitted during a period of five years are presented. Incidence of liver abscess was 0.20 per cent of hospital admissions. A peak age incidence in the 4th decade, male preponderance, pain and fever were the striking features. The majority of the abscesses were localised to a single lobe (90.0%). The abscess was sited in the right lobe in 75.1 per cent, in the left lobe in 18.3 per cent and in both lobes in 6.7 per cent. Elevation and limitation of movement of the right dome of the diaphragm was present in 89.5 per cent of cases. Depending upon therapeutic response, aspiration or/and surgical drainage was undertaken. Aspiration was done in 169 patients and surgical drainage in 63 patients. Management of pyogenic liver abscess included early operative intervention preceded by appropriate antibiotic therapy. Surgical intervention is required less often in amoebic abscess and is recommended only after amoebicidal therapy. Open drainage is recommended for the cases associated with complications, left lobe abscess and big abscess.
本文介绍了五年期间收治的240例肝脓肿患者的临床特征及外科治疗情况。肝脓肿的发病率占住院患者的0.20%。发病高峰年龄在40岁，男性居多，疼痛和发热是其显著特征。大多数脓肿局限于单个肝叶（90.0%）。脓肿位于右叶的占75.1%，位于左叶的占18.3%，位于双侧叶的占6.7%。89.5%的病例出现右侧膈穹窿抬高及活动受限。根据治疗反应，进行穿刺抽吸或/和手术引流。169例患者进行了穿刺抽吸，63例患者进行了手术引流。化脓性肝脓肿的治疗包括在适当抗生素治疗后尽早进行手术干预。阿米巴脓肿较少需要手术干预，仅在抗阿米巴治疗后才建议手术。对于伴有并发症、左叶脓肿和大脓肿的病例，建议采用开放引流。
