發(fā)布時間：2019-02-16 12:44

【摘要】：目的:總結(jié)合并糖尿病的細菌性肝膿腫臨床特點,并研究柴胡清肝湯聯(lián)合西醫(yī)治療該病的療效。方法:回顧性分析2011年4月至2015年6月薊縣人民醫(yī)院收治的40例合并糖尿病的細菌性肝膿腫患者(其中20例應(yīng)用柴胡清肝湯聯(lián)合西醫(yī)治療,另外20例應(yīng)用單純西醫(yī)方法治療)的病因、臨床表現(xiàn)、實驗室檢查、影像學(xué)檢查、治療方法及預(yù)后等資料。結(jié)果:1.所有患者中男26例,女14例,年齡30~80歲,平均(59.28±11.78)歲。所有患者均有發(fā)熱,熱型不規(guī)則,體溫高峰38.2~41.0℃,伴惡心、嘔吐者18例,納差、食欲減退者28例,自覺肝區(qū)疼痛者26例,肝區(qū)有叩擊痛者33例。入院后化驗血糖平均(14.95±5.65)mmol/L,糖化血紅蛋白(9.12±2.44)%。所有患者均進行了細菌培養(yǎng)(血液和/或膿液),其中血培養(yǎng)24例,其中6例陽性,分別為肺炎克雷伯菌4例,大腸埃希菌2例,膿液培養(yǎng)16例,其中陽性5例,分別為3例肺炎克雷伯桿菌,1例大腸桿菌,1例金黃色葡萄球菌。影像學(xué)檢查提示肝右葉膿腫24例、左葉膿腫7例,兩葉均有9例;其中膿腫單發(fā)者27例,多發(fā)13例,膿腔大小范圍為2.0cm×1.8cm~11.8cm×8.8cm。2.柴胡清肝湯聯(lián)合西醫(yī)治療該病有效率95%,平均住院時間13.30±3.36天,西醫(yī)治療組有效率85%,平均住院時間(18.45±5.23)天。結(jié)論:1.合并糖尿病的細菌性肝膿腫患者以老年人多見;隱匿性感染比例高;臨床表現(xiàn)不典型;大多血糖控制不良、營養(yǎng)狀況差;細菌培養(yǎng)陽性率低,肺炎克雷伯桿菌多見;膿腫多為單發(fā),以右葉多見。2.柴胡清肝湯聯(lián)合西醫(yī)治療合并糖尿病的細菌性肝膿腫療效顯著。
[Abstract]:Objective: to summarize the clinical features of bacterial liver abscess complicated with diabetes and to study the curative effect of Chaihu Qinggan decoction combined with western medicine. Methods: from April 2011 to June 2015, 40 patients with bacterial liver abscess complicated with diabetes mellitus were analyzed retrospectively. Among them, 20 cases were treated with Chaihu Qinggan decoction combined with western medicine. The etiology, clinical manifestation, laboratory examination, imaging examination, treatment method and prognosis of 20 cases. Results: 1. There were 26 males and 14 females, aged 30 to 80 years (mean (59.28 鹵11.78) years old). All patients had fever, irregular heat type, temperature peak of 38.2 鈩，

本文編號：2424466