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    Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/1940


    Title: 化膿性肝膿瘍-臨床分析
    A Clinical Study on Pyogenic Liver Abscess
    Authors: 陳滋彥;陳丹霞;何尉旗;林俊哲;林金坤;何錄滄
    Tzy-Yen Chen;Tan-Hsia Chen;Wei-Chi Ho;Chun-Che Lin;Chin-Kun Lin;Lu-Chang Ho
    Contributors: 中山醫學大學
    Keywords: 化膿性肝膿瘍;經皮穿肝引流術
    pyogenic liver abscess;percutaneous transhepatic drainage;aspiration
    Date: 2003-12-01
    Issue Date: 2010-07-28T09:23:56Z (UTC)
    Publisher: 教務處出版組
    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。
    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.
    URI: https://ir.csmu.edu.tw:8080/handle/310902500/1940
    Relation: 中山醫學雜誌, v14 n.4 p495-503
    Appears in Collections:[教務處] 期刊論文

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