Georges R N, Deitch E A
Department of Surgery, Louisiana State University Medical Center, Shreveport.
South Med J. 1993 Nov;86(11):1233-5. doi: 10.1097/00007611-199311000-00009.
We reviewed the clinical courses of 37 patients treated for pyogenic liver abscesses. These abscesses were cryptogenic in 38% of the patients, associated with biliary tract or intra-abdominal disease processes in 48%, and hematogenous in 11%. Computed tomography was more accurate (96%) in diagnosing a hepatic abscess than ultrasonography (82%). The majority of the patients were treated initially with percutaneous drainage (18) or needle aspiration drainage (5); treatment failure occurred in 9 of these 23 patients (39%). In contrast, there were no treatment failures in the 9 patients treated with primary operation. Overall, 4 of the 37 patients died (a mortality rate of 11%) but 2 of them died of underlying malignant disease rather than the liver abscess.
我们回顾了37例化脓性肝脓肿患者的临床病程。这些脓肿在38%的患者中病因不明，48%与胆道或腹腔内疾病过程相关，11%为血源性。计算机断层扫描在诊断肝脓肿方面比超声检查更准确（96%对82%）。大多数患者最初接受经皮引流（18例）或针吸引流（5例）；这23例患者中有9例治疗失败（39%）。相比之下，9例接受一期手术治疗的患者没有治疗失败。总体而言，37例患者中有4例死亡（死亡率为11%），但其中2例死于潜在的恶性疾病而非肝脓肿。
