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目的总结糖尿病并细菌性肝脓肿(DPHA)的临床特点和诊治经验。方法回顾性分析我院2002年3月至2010年12月期间出院的DPHA与无DPHA(NDPHA)患者的临床资料。结果细菌性肝脓肿患者共22例,其中DPHA患者11例。DPHA组人口学特征、临床表现、白细胞计数与NDPHA组比较差异均无统计学意义(P>0.05);DPHA组血白蛋白低于NDPHA(P=0.006),而ALT高于NDPHA(P=0.006)。DPHA组病灶个数多于NDPHA组(P=0.032),且病灶直径也大于NDPHA组(P=0.006)。脓培养:2组大肠杆菌均为3例;DPHA组克雷伯杆菌4例,而NDPHA组无克雷伯杆菌。DPHA组发生切口感染7例、腹腔感染2例,NDPHA组发生切口感染3例。DPHA组抗生素使用时间、住院时间及住院费用均高于NDPHA组(P<0.05)。2组均分别治愈6例、好转5例,2组均无死亡患者。结论 DPHA有其特殊的临床特征,并发症多,住院费用高,但预后与NDPHA差别不大。
Objective To summarize the clinical features and diagnosis and treatment of diabetes and bacterial liver abscess (DPHA). Methods The clinical data of patients with DPHA and without DPHA (NDPHA) discharged from our hospital from March 2002 to December 2010 were retrospectively analyzed. Results A total of 22 patients with bacterial liver abscess, including 11 DPHA patients. There were no significant differences in demographic characteristics, clinical manifestations and leukocyte counts between DPHA group and NDPHA group (P> 0.05), while serum levels of serum albumin in DPHA group were lower than those in NDPHA group (P = 0.006) ). The number of lesions in DPHA group was more than that in NDPHA group (P = 0.032), and the lesion diameter was also larger than that in NDPHA group (P = 0.006). Pus culture: two groups of E. coli were 3 cases; DPHA group Klebsiella in 4 cases, while NDPHA group without Klebsiella. Incision infection in DPHA group in 7 cases, abdominal infection in 2 cases, NDPHA group incision infection in 3 cases. The antibiotic use time, hospital stay and hospital expenses in DPHA group were higher than those in NDPHA group (P <0.05). Two groups were cured 6 cases, improved in 5 cases, two groups were no deaths. Conclusion DPHA has its special clinical features, complications, hospitalization costs, but the prognosis and NDPHA little difference.