Tian Yu, Hao Diandian, Du Jialin, Wang Hui, Wen Xiaoyu
Department of Hepatic-Biliary-Pancreatic Medicine, the First Hospital of Jilin University, Changchun, Jilin Province.
Department of Cardiovascular Medicine, Dandong Central Hospital, Dandong, Liaoning Province, China.
Eur J Gastroenterol Hepatol. 2025 Apr 1;37(4):483-487. doi: 10.1097/MEG.0000000000002906. Epub 2024 Dec 9.
This study aimed to summarize the clinical and microbiological characteristics of patients with pyogenic liver abscess (PLA) and to explore the clinical features of PLA with extrahepatic migratory infection (EMI).
A retrospective analysis was conducted on clinical data from 1800 PLA patients at Jilin University First Hospital from January 2019 to December 2023. Patients were divided into two groups based on the presence of EMI: with EMI and without EMI. Clinical features and prognoses of the two groups were compared using rank-sum tests and chi-square tests for continuous and categorical data, respectively.
PLA patients were predominantly male (65.56%) with an average age of 60. Abscesses were mainly located in the right lobe (64.83%) and were often single (68.17%). Klebsiella pneumoniae was the primary pathogen (68.46%), with 9.50% of strains being multidrug-resistant. The majority of patients improved with effective treatment (96.17%). Compared with the non-EMI group, patients with EMI were younger, had longer hospital stays, smaller abscesses, and a higher incidence of diabetes and cerebrovascular disease, with poorer prognoses.
PLA is most commonly observed in middle-aged and elderly males, often presenting as single abscesses in the right lobe, with diabetes as a frequent underlying condition. Most patients recover with appropriate antibiotic treatment and ultrasound-guided drainage. PLA patients with EMI generally have poorer outcomes and require special attention.
本研究旨在总结化脓性肝脓肿（PLA）患者的临床和微生物学特征，并探讨伴有肝外迁徙性感染（EMI）的PLA的临床特点。
对吉林大学第一医院2019年1月至2023年12月期间1800例PLA患者的临床资料进行回顾性分析。根据是否存在EMI将患者分为两组：有EMI组和无EMI组。分别采用秩和检验和卡方检验比较两组的临床特征和预后，连续数据和分类数据分别进行分析。
PLA患者以男性为主（65.56%），平均年龄60岁。脓肿主要位于右叶（64.83%），且多为单发（68.17%）。肺炎克雷伯菌是主要病原体（68.46%），其中9.50%的菌株为多重耐药。大多数患者经有效治疗后病情改善（96.17%）。与无EMI组相比，有EMI的患者年龄更小，住院时间更长，脓肿更小，糖尿病和脑血管疾病的发生率更高，预后更差。
PLA最常见于中老年男性，常表现为右叶单发脓肿，糖尿病是常见的基础疾病。大多数患者通过适当的抗生素治疗和超声引导下引流可康复。伴有EMI的PLA患者总体预后较差，需要特别关注。
