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目的:分析2型糖尿病并发细菌性肝肿的临脓床特点及治疗,为减少临床医师漏诊误诊,及更好的治疗提供依据。方法:回顾性分析116例2型糖尿病合并细菌性肝脓肿患者的基础疾病、症状体征、实验室检查、影像学检查、病原学检查、治疗情况。结果:116例2型糖尿病并发细菌性肝脓肿患者中,只有45例患者出现腹痛,116例中大部分呈现出空腹血糖、外周血中性粒细胞百分数、血沉、C-反应蛋白升高,而血红蛋白、血浆白蛋白、胆固醇明显下降,呈“四高三低”现象。64例患者在B超引导下经皮经肝穿刺引流术,41例行内科保守治疗,8例行开腹肝脓肿切开引流,3例行腹腔镜脓肿切开引流,110例好转出院。结论:2型糖尿病并发细菌性肝脓肿临床表现不典型,C反应蛋白、血沉和B超有助于减少疾病的漏诊、误诊;治疗应及时纠正高血糖,抗感染,脓肿予以穿刺引流,必要时切开引流。
Objective: To analyze the characteristics and treatment of clinical pus in patients with type 2 diabetes complicated with bacterial hepatomegaly, and to provide basis for reducing the misdiagnosis of clinicians and better treatment. Methods: A retrospective analysis of 116 cases of type 2 diabetes with bacterial liver abscess in patients with underlying diseases, symptoms and signs, laboratory tests, imaging studies, etiological examination, treatment. Results: Of 116 patients with type 2 diabetes complicated with bacterial liver abscess, only 45 patients had abdominal pain. Most of the 116 patients showed fasting blood glucose, peripheral blood neutrophil percentage, erythrocyte sedimentation rate and elevated C-reactive protein Hemoglobin, plasma albumin, cholesterol decreased significantly, was “four high and three low” phenomenon. Sixty-four patients underwent percutaneous transhepatic puncture and drainage under the guidance of B-mode ultrasound. 41 patients underwent conservative medical treatment, 8 underwent open hepatic abscess drainage and drainage, 3 underwent laparoscopic abscess incision and drainage, and 110 patients were discharged. Conclusion: The clinical manifestations of type 2 diabetes complicated with bacterial liver abscess are not typical. C-reactive protein, erythrocyte sedimentation rate and B-ultrasound help to reduce the misdiagnosis and misdiagnosis of the disease. The treatment should promptly correct the hyperglycemia, anti-infective and abscess to puncture and drainage, Cut the drainage.