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目的 探讨老年细菌性肝脓肿的临床特点。 方法 对 1993年 1月～ 1999年 12月间收治的细菌性肝脓肿作回顾性研究 ,比较老年组和中青年组患者的临床特点。 结果 与中青年组比较 ,老年组伴有胸水(87 5 %vs 45 8% )、腹水 (37 5 %vs 8 3 % )、大脓腔 (10 0 %vs 6 6 7% )、胆道疾病 (5 6 3 %vs 2 9 2 % )、糖尿病 (37 5 %vs 4 2 % )的比例显著升高 ,而血浆白蛋白 [(2 8 1± 6 0 )g·L-1vs (33 4± 4 8)g·L-1]、血红蛋白 [(95 2± 2 2 5 )g·L-1vs (99 7± 17 0 )g·L-1]水平明显下降。使用抗生素 (10例 )和经肝抽脓术 (4例 )占治疗总数的 87 5 %。治疗总有效率为 93 8%。 结论 老年细菌性肝脓肿的发生与胆道疾病、糖尿病有关。抗生素和经肝抽脓术是本病的主要治疗手段。伴有严重贫血、低蛋白血症的患者应予积极纠正。
Objective To investigate the clinical features of bacterial liver abscess in the elderly. Methods A retrospective study was performed on bacterial liver abscess treated between January 1993 and December 1999. The clinical features of the elderly and middle-aged patients were compared. Results Compared with middle-aged and young patients, the elderly patients had pleural effusion (87.5% vs 45.8%), ascites (37.5% vs 83%), abscess (100% vs 67.6%), biliary disease (36.5% vs 29.2%) and diabetes (37.5% vs 42.2%). However, the plasma albumin level was significantly lower than that of the control group [(281 ± 60) g · L -1 vs 8) g · L-1] and hemoglobin [(95 2 ± 2 2 5) g · L -1 vs (99 7 ± 17 0) g · L -1]). The use of antibiotics (10 cases) and transhepthorax (4 cases) accounted for 87.5% of the total number of treatments. The total effective rate was 93 8%. Conclusion The incidence of bacterial liver abscess in elderly patients is related to biliary disease and diabetes. Antibiotics and pus by the liver is the main treatment of this disease. Patients with severe anemia, hypoproteinemia should be actively corrected.