双重细菌性肝脓肿7例病原学和临床特点
Pathogenic and clinical characteristics of 7 cases of double bacterial hepatic abscess
李智德 1宋巍 1马志刚 1李玉鹏 1田广磊 1马超 1陈雄1
作者信息
- 1. 新疆维吾尔自治区人民医院肝胆外科,新疆乌鲁木齐 830001
- 折叠
摘要
目的 探讨7例双重细菌性肝脓肿患者的病原学特点及临床特点.方法 回顾性分析该院2015年1月至2021年10月收治的7例双重细菌性肝脓肿患者的临床资料,分析细菌谱及临床表现、并发症等,总结双重细菌性肝脓肿的临床特点.结果 7例双重细菌性肝脓肿患者年龄22.0～78.0岁,平均(58.9± 17.7)岁,平均住院时间(15.6±10.9)d,6例(85.7％)合并基础疾病及既往有手术史,发热(71.4％)、腹痛(57.1％)为主要症状,肺炎和胸腔积液为主要并发症.脓肿平均直径为(6.1±3.2)cm,所有患者均行经皮经肝脓肿穿刺引流术联合抗生素抗感染而治愈.所有患者均出现不同程度肝功能损伤.主要致病菌为肺炎克雷伯杆菌和大肠埃希菌,头孢类、喹诺酮类抗生素耐药比例均为57.1％(4/7),碳青霉烯类抗生素耐药比例为28.6％(2/7).结论 双重肝脓肿好发于合并基础疾病及腹部手术史的老年人,肺炎克雷伯杆菌和大肠埃希菌为主要致病菌,且易耐药.
Abstract
Objective To explore the pathogenic and clinical characteristics of 7 cases of double bacteri-al hepatic abscess.Methods The clinical data of 7 cases of double bacterial hepatic abscess treated in this hos-pital from January 2015 to December 2021 were analyzed retrospectively.The bacterial spectrum,clinical man-ifestations and complications were analyzed,and the clinical characteristics of double mixed bacterial hepatic abscess were summarized.Results In 7 cases of double mixed bacterial hepatic abscess,the age was 22.0-78.0 years old,the mean age was(58.9+17.7)years old,the mean hospital stay time was(15.6±10.9)d.Six cases(85.7％)were complicated with underlying disease and previous surgical history.Fever(71.4％)and abdominal pain(57.1％)were the main symptoms.Pneumonia and pleural effusion were the main complica-tions.The mean diameter of hepatic abscess was(6.1±3.2)cm,and all patients were cured by percutaneous puncture and drainage of hepatic abscess combined with antibiotics for anti-infection treatment.All patients had varied degree of liver function injury.The main pathogenic bacteria were Klebsiella pneumoniae and Esch-erichia coli.The proportions of cephalosporin and quinolone antibiotic resistance all were 57.1％(4/7),and carbopenem antibiotic resistance proportion was 28.6％(2/7).Conclusion Double mixed hepatic abscess usu-ally occurs in the elderly patients with complicating underlying disease and previous surgical history.Klebsiel-la pneumoniae and Escherichia coli are main pathogenic bacteria,moreover which are easy to have drug resist-ance.
关键词
细菌性肝脓肿/病原学/临床特点Key words
Bacterial liver abscess/Etiology/Clinical characteristics引用本文复制引用
基金项目
新疆维吾尔自治区区域协同创新专项()
上海合作组织科技伙伴计划()
国际科技合作计划(ZYYD2023C09)
新疆维吾尔自治区创新环境(人才、基地)建设专项(人才专项计划-天山创新团队)(2021D14005)
新疆维吾尔自治区人民医院院内项目(20220201)
新疆维吾尔自治区人民医院院内项目(20200214)
出版年
2024
国家科技期刊平台
NSTL
万方数据