Rintoul R, O'Riordain M G, Laurenson I F, Crosbie J L, Allan P L, Garden O J
University Department of Surgery, Royal Infirmary, Edinburgh, UK.
Br J Surg. 1996 Sep;83(9):1215-8.
The case records of 23 patients who presented over a 5-year period with a diagnosis of pyogenic liver abscess were reviewed. Ascending cholangitis was implicated in nine cases, seven of which were associated with underlying malignancy. Haematogenous spread via the portal route accounted for five cases. Primary treatment included percutaneous abscess drainage in 15 patients. Whereas nine of the 11 patients with benign underlying pathology were managed successfully, the four with malignant biliary obstruction did not survive. Only one of the 23 patients who presented with hepatic abscess required surgical intervention. Percutaneous abscess drainage combined with appropriate antibiotic therapy is an effective means of managing hepatic abscess, but there remains a substantial overall mortality rate resulting from the increasing incidence of malignant biliary obstruction as a cause of this condition.
回顾了23例在5年期间被诊断为化脓性肝脓肿的患者的病例记录。9例与上行性胆管炎有关，其中7例与潜在恶性肿瘤相关。经门静脉的血行播散占5例。主要治疗方法包括15例患者的经皮脓肿引流。11例有良性基础病变的患者中有9例成功治愈，而4例恶性胆管梗阻患者未能存活。23例肝脓肿患者中只有1例需要手术干预。经皮脓肿引流联合适当的抗生素治疗是治疗肝脓肿的有效方法，但由于恶性胆管梗阻作为该疾病病因的发病率增加，总体死亡率仍然很高。
