Title

A Clinical Study on Pyogenic Liver Abscess

Translated Titles

化膿性肝膿瘍-臨床分析

DOI

10.30096/CSMJ.200312.0002

Authors

陳滋彥(Tzy-Yen Chen);陳丹霞(Tan-Hsia Chen);何尉旗(Wei-Chi Ho);林俊哲(Chun-Che Lin);林金坤(Chin-Kun Lin);何錄滄(Lu-Chang Ho)

Key Words

化膿性肝膿瘍 ; 經皮穿肝引流術 ; pyogenic liver abscess ; percutaneous transhepatic drainage ; aspiration

PublicationName

中山醫學雜誌

Volume or Term/Year and Month of Publication

14卷4期(2003 / 12 / 01)

Page #

495 - 503

Content Language

英文

Chinese Abstract

中山醫學大學附設醫院大慶院區從1998年7月至2003年12月共5年6個月間,經由抽吸或手術確定為化膿性肝膿瘍者共有94例,男女比例為1.4比1,死亡例8例,佔8.5%。臨床表現以發燒90.4%,畏寒84%最為常見,其次為右上腹疼痛54.2%。膿瘍數目以單一性居多,77.6%,且好發於右葉(82.9%)。主要的伴隨原因為糖尿病(36.2%)、膽石症(26.6%)、原因不明者(18.1%)、癌症(9.5%)。菌血症為最常見的併發症(52.9%)。實驗性檢查以白血球增加(90.4%)最為常見。預後不好的因素有:1.年齡40歲以上,2. 癌症病人,3.腹膜炎,4.多發膿瘍,5.兩葉侵犯,6.多種病原菌,7.血液培養陽性。 致病菌以嗜氧性革蘭氏陰性桿菌為主(87.7%),而厭氧菌的培養陽性率為5.5%。治療方法以抽吸或經皮穿肝引流為主,少數則接受開刀治療。

English Abstract

Pyogenic liver abscess is an uncommon complication of intra-abdominal or biliary tract infection and is usually a polymicrobial infection associated with high mortality and high rates of relapse in western countries. However, over the past five and a half years, in the newly founded Taching Hospital, we have treated ninety-four patients (male-to-female ratio 1.4:1) with pyogenic liver abscesses. The abscesses were confirmed in all 94 patients by needle aspiration or operation. Eight patients (8.5%) died. Its clinical symptoms are, fever (90.4%), chills (84%), and right quadrant pain (54.2%). The majority of these abscesses are solitary (77.6%) and mostly found in the right lobe (82.9%). The major underlying predisposing causes for these abscesses are diabetes mellitus (D.M.)(36.2%), biliary tract stones (26.6%), cryptogenic abscess (18.1%), and cancer (9.5%). Bacteremia is the most common complication (52.9%). The most common I aboratory findings are leukocytosis (92%) and elevated alkaline phosphatase level (85%). Gram negative bacilli were the most common bacteria encountered (87.7%). The positive culture rates for anaerobes was 5.5%.The most commonly used therapeutic measure was Pyogenic liver abscess is an uncommon complication of intra-abdominal or biliary tract infection and is usually a polymicrobial infection associated with high mortality and high rates of relapse in western countries. However, over the past five and a half years, in the newly founded Taching Hospital, we have treated ninety-four patients (male-to-female ratio 1.4:1) with pyogenic liver abscesses. The abscesses were confirmed in all 94 patients by needle aspiration or operation. Eight patients (8.5%) died. aspiration or continuous percutaneous transhepatic drainage. Three patients underwent surgical intervention.

Topic Category 醫藥衛生 > 醫藥衛生綜合