2型糖尿病合并肝脓肿患者的临床特征分析

Analysis in clinical characteristics of type 2 diabetes mellitus complicated with liver abscess

  • 摘要:
      目的  分析2型糖尿病合并肝脓肿患者的临床特征。
      方法  选取316例肝脓肿患者作为研究对象,按是否患有2型糖尿病分为糖尿病组144例和非糖尿病组172例,分析2组患者的一般情况、基础疾病、临床症状和体征、实验室检查结果、影像学检查结果以及病原学检查结果。
      结果  糖尿病组腹痛和腹胀、腹部压痛和反跳痛、肝区叩痛者比率低于非糖尿病组,差异有统计学意义(P < 0.05); 糖尿病组白蛋白、血小板、γ-谷氨酰胺转肽酶水平低于非糖尿病组,差异有统计学意义(P < 0.05或P < 0.01); 糖尿病组脓肿直径>10 cm者比率高于非糖尿病组,差异有统计学意义(P < 0.05); 糖尿病组败血症发生率高于非糖尿病组,差异有统计学意义(P < 0.05); 糖尿病组血培养及脓液培养的肺炎克雷伯菌阳性率均高于非糖尿病组,差异有统计学意义(P < 0.05或P < 0.01); 治疗后随访发现,糖尿病组残余脓肿直径5~10 cm者比率高于非糖尿病组,差异有统计学意义(P < 0.05)。
      结论  2型糖尿病合并肝脓肿患者的临床表现不典型,易误诊、漏诊,确诊后积极选用敏感抗菌药物治疗,控制血糖,并结合脓肿穿刺等治疗,可取得良好疗效。

     

    Abstract:
      Objective  To analyze the clinical characteristics of patients with diabetes and liver abscess.
      Methods  A total of 316 patients with liver abscess were selected as study objects, and were divided into diabetes mellitus group(n=144)and non-diabetes group(n=172) according to whether the patients suffered from type 2 diabetes or not. The general conditions, basic diseases, clinical symptoms and signs, laboratory examination results, imaging findings and etiological examination results of the two groups were analyzed.
      Results  The rates of patients with abdominal pain and abdominal distension, abdominal tenderness and rebound pain, and percussion pain in the liver area in the diabetic group were significantly lower than those in the non-diabetic group(P < 0.05). The levels of albumin, blood platelet and γ-glutamine transpeptidase in the diabetic group were significantly lower than those in the non-diabetic group (P < 0.05 or P < 0.01). The proportion of abscess diameter over 10 cm and incidence of sepsis in the diabetic group were significantly higher than those in the non-diabetic group (P < 0.05). The positive rates of Klebsiella pneumoniae in blood and pus culture in the diabetic group were significantly higher than those in the non-diabetic group (P < 0.05 or P < 0.01). Follow-up after treatment showed that the proportion of residual abscess with diameter of 5 to 10 cm in the diabetic group was significantly higher than that in the non-diabetic group (P < 0.05).
      Conclusion  Because of atypical clinical manifestations of diabetes mellitus complicated with liver abscess, misdiagnose and missed diagnosis may easily occur. Once diagnosed, sensitive antibiotics, blood sugar control and puncture treatment should be implemented so as to achieve better curative effect.

     

/

返回文章
返回