- 期刊
Pyogenic Liver Abscess: Comparison between Single and Multiple Abscesses
化膿性肝膿瘍：單一和多發性之比較
摘要
背景：化膿性肝膿瘍如未接受適當治療，會導致相當高的死亡率。這篇研究是為了評估單一和多發性化膿性肝膿瘍二者之間的差異。 研究方法及對象：共有33位符合化膿性肝瘍之診斷要件納入研究，其中25位是單一化膿性肝膿瘍，其中8位是多發性化膿性肝膿瘍。我們研究的重點放在肝膿瘍數目對病患的影響，其他記錄的資料包括有：實驗室數據、臨床表現、年齡、性別、肝葉的分佈、微生物數據、糖尿病病史、膿瘍內是否產氣、處理方法及治療結果。 研究結果：在這個研究中發現，化膿性肝膿瘍，不論是單一或是多發性的，都好發於男性。最常見原來存有的疾病是糖尿病。發燒、寒顫及腹痛是最常出現的症狀。革蘭氏陰性菌是主要致病病源，而克氏肺炎桿菌為最常被分離出之菌種。病患接受經皮引流術的平均時間是13天，成功率為84%。在單一膿瘍組群有一患者死亡及四位復發。 結論：單一性及多發性肝膿瘍之間並沒有明顯之差異，早期診斷、及時治療是這類疾病的必要處理方式。早期診斷的關鍵在於將任何不明原因的發燒及腹痛列入肝膿瘍的鑑別診斷，特別是糖尿病患者。
並列摘要
Background: Pyogenic liver abscess, without treatment, carries a high mortality rate. The purpose of this study was to evaluate the similarities and differences between patients with single and multiple abscesses. Materials and Methods: Thirty-three patients with pyogenic liver abscess who fulfilled the described criteria were studied., Twenty-five had a single abscess and 8 had multiple abscesses. Patient characteristics, underlying disease, clinical manifestations, microbiology, methods of treatment, and outcomes were evaluated and compared between the two groups. Results: In both groups, men predominated and diabetes mellitus was the most common underlying disease. Symptoms and signs were nonspecific; fever, abdominal pain and chills were common. Abscess and blood cultures yielded a higher proportion of monomicrobial pathogens. Klebsiella pneumoniae was the most common isolated organism. The average duration of percutaneous drainage was 13 days and overall success rate of percutaneous treatment was 84%. One patient died and four recurrences were noted in the single abscess group. There were no mortalities in the multiple abscess group. Conclusions: No significant differences were found between the two groups. Early diagnosis and prompt treatment are the prerequisites for cure. The key to early diagnosis is consideration of liver abscess in the differential diagnosis of any unexplained febrile illness with abdominal pain especially in diabetic patients.