【摘要】：目的：探討2型糖尿病與非糖尿病患者合并細菌性肝膿腫臨床特點差異，為其診斷、治療提供依據(jù)。 方法：回顧分析細菌性肝膿腫患者75例臨床資料，其中2型糖尿病并發(fā)細菌性肝膿腫28例（DM組），非糖尿病細菌性肝膿腫47例（非DM組），比較兩組一般資料、臨床表現(xiàn)、輔助檢查、肝膿腫特點、治療方法及療效等。 結(jié)果：兩組年齡及性別差異無統(tǒng)計學(xué)意義(P0.05)，兩組上腹痛癥狀、腹部壓痛體征差異有統(tǒng)計學(xué)意義(P0.05)；實驗室檢查兩組比較白細胞計數(shù)、總膽紅素、直接膽紅素、間接膽紅素升高及血小板計數(shù)300×109/L例數(shù)差異有統(tǒng)計學(xué)意義(P0.05)；膿液細菌培養(yǎng)陽性率及肺炎克雷伯桿菌培養(yǎng)率兩組比較差異有顯著性(P0.025)；兩組抗菌藥物使用時間差異有統(tǒng)計學(xué)意義(P0.05)。DM組患者延誤診治較非DM組多，差異有統(tǒng)計學(xué)意義(P0.05)。75例細菌性肝膿腫患者經(jīng)過綜合治療后均好轉(zhuǎn)出院。 結(jié)論：糖尿病并發(fā)肝膿腫患者癥狀體征不明顯，，容易漏診誤診，且易并發(fā)其他部位感染，病原菌以肺炎克雷伯桿菌多見，治療應(yīng)強調(diào)有效控制血糖、及時穿刺治療、合理、足量應(yīng)用抗菌藥物、膿腔個體化治療和營養(yǎng)支持，從而提高療效，降低住院費用。
[Abstract]:Objective: to explore the difference of clinical features between type 2 diabetes mellitus and non-diabetic patients with bacterial liver abscess. Methods: the clinical data of 75 patients with bacterial liver abscess were retrospectively analyzed, including 28 cases of type 2 diabetes complicated with bacterial liver abscess (DM group) and 47 cases of non-diabetic bacterial liver abscess (non-DM group). Auxiliary examination, characteristics of liver abscess, treatment method and curative effect etc. Results: there was no significant difference in age and sex between the two groups (P0.05). There were significant differences in symptoms and signs of abdominal tenderness between the two groups (P0.05). The white blood cell count, total bilirubin, direct bilirubin, indirect bilirubin and platelet count of 300 脳 109 / L were significantly different between the two groups (P0.05). The positive rate of bacterial culture in pus was significantly higher than that of Klebsiella pneumoniae (P0.025). There was significant difference between the two groups in the time of use of antibiotics (P0.05). 75 patients with bacterial liver abscess were discharged after comprehensive treatment. (P0.05) there was more delay in diagnosis and treatment in the). DM group than in the non-DM group (P0.05). Conclusion: the symptoms and signs of patients with diabetes mellitus complicated with liver abscess are not obvious, it is easy to miss diagnosis and misdiagnosis, and it is easy to be complicated with infection of other parts. Klebsiella pneumoniae is the most common pathogen. The treatment should emphasize the effective control of blood sugar, timely puncture treatment and reasonable treatment. Adequate use of antimicrobial agents, individualized treatment of pus cavity and nutritional support, so as to improve the efficacy and reduce hospital costs.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R587.1;R575.4

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