细菌性肝脓肿诊断和外科治疗

［摘要］  目的  总结细菌性肝脓肿的临床诊断和外科治疗经验。方法  回顾性分析1998年1月～2006年8月98例细菌性肝脓肿病人的诊断与外科治疗方法。结果  诊断细菌性肝脓肿91例，27例经B超引导肝穿刺置管引流，62例肝脓肿切开引流或加大网膜填塞，13例腹腔镜置管引流，2例肝部分切除。结论  细菌性肝脓肿诊断依据临床表现及B超和CT/MRI检查，外科治疗采用B超引导肝穿刺置管引流、手术切开引流或加大网膜填塞、腹腔镜置管引流、肝部分切除术。

    ［关键词］  细菌性肝脓肿；诊断；外科治疗

      Diagnosis and surgical treatment of bacteria liver abscess:a report of 98 cases

    ［Abstract］  Objective  To summarize the experience in diagnosis and surgical treatment of bacteria liver abscess.Methods  Diagnosis and treatment of 98 patients with bacteria liver abscess admitted from Jan.1998 to Aug.2006 were retrospectively reviewed.Results  91 patients were diagnosed as bacteria liver abscess.Treating by the puncture drainage for liver abscess under B ultrasound guidance，incision and drainage or add plugging of greater omentum，laparoscopic drainage，regional hepatectomy were in 27，62，13 and 2 cases respectively.Conclusion  Diagnosis of bacteria liver abscess was based of the clinic performance，B ultrasound and CT/MRI.The surgical treatment can adopt puncture drainage for liver abscess under B ultrasound guidance，incision and drainage or add plugging of greater omentum，laparoscopic drainage，regional hepatectomy.

    ［Key words］  bacteria liver abscess；diagnosis；surgical treatment

    近年来随着对肠道传染病的有效控制、抗生素的不断更新换代以及人类疾病谱的变化和许多新技术的开展，肝脓肿的发病率、病因、临床表现以及治疗措施均已发生了很大的变化，并发症发生率和病死率也有显著降低。Hashimoto等［1］报道病死率已由原来的70%下降到近年来的0～15%。但在我国，特别是边远少数民族地区，仍存在及时诊断和正确选择处理方法以及进一步降低并发症发生率和病死率的问题。我院自1998年1月～2006年8月收治98例细菌性肝脓肿经外科治疗。本文就细菌性肝脓肿的诊断和治疗探讨如下。

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