el Hassani S, Bensabbah R, Attaibi A, Kabiri H, Bourki K, Balafrej S, Hajjaj-Hassouni N
Rheumatology B Department, El Ayachi-Salé Teaching Hospital, Rabat, Morocco.
Rev Rhum Engl Ed. 1998 Oct;65(10):555-9.
Most psoas abscesses are secondary. The objective of this study was to report on the clinical features, diagnosis and treatment of primary psoas abscess.
We retrospectively studied 16 cases seen over a ten-year period (1987-1997) and compared our findings to published data.
There were 14 men and two women, with a mean age of 6 years (range, 17-57 years). The right side was affected in nine cases, the left side in six, and both sides in one. Fever, pain and psoas spasm were the presenting symptoms. Laboratory tests for inflammation were positive; four patients had a high neutrophil count. Ultrasonography demonstrated a fluid collection in the psoas in 13 patients. A computed tomography scan was done in 14 patients and showed either a fluid collection (n = 11) or a presuppurative abscess (n = 3). Magnetic resonance imaging was not used. The organism was recovered in nine patients and was a Staphylococcus aureus in seven, an Escherichia coli in one and a Pseudomonas aeruginosa in one. The Brucella agglutination test was strongly positive in two patients. Findings were negative from investigations done to look for a cause (discitis, urinary tract infection, Crohn's disease, ulcerative colitis, malignancy or infection in the vicinity of the psoas muscle). All patients received antimicrobial therapy. Drainage was percutaneous in six patients and surgical in ten. The outcome was favorable in every case.
多数腰大肌脓肿为继发性。本研究的目的是报告原发性腰大肌脓肿的临床特征、诊断及治疗情况。
我们回顾性研究了10年间（1987 - 1997年）收治的16例患者，并将我们的研究结果与已发表的数据进行比较。
14例男性，2例女性，平均年龄6岁（范围17 - 57岁）。右侧受累9例，左侧6例，双侧1例。发热、疼痛及腰大肌痉挛为主要症状。炎症实验室检查呈阳性；4例患者中性粒细胞计数升高。超声检查显示13例患者腰大肌有液性积聚。14例患者行计算机断层扫描，其中11例显示有液性积聚，3例显示为化脓前期脓肿。未使用磁共振成像检查。9例患者培养出病原体，7例为金黄色葡萄球菌，1例为大肠杆菌，1例为铜绿假单胞菌。2例患者布鲁氏菌凝集试验呈强阳性。寻找病因（椎间盘炎、尿路感染、克罗恩病、溃疡性结肠炎、恶性肿瘤或腰大肌附近感染）的检查结果均为阴性。所有患者均接受了抗菌治疗。6例行经皮引流，10例行手术引流。所有病例预后良好。
