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Surgical management of pyogenic liver abscess.

机译:化脓性肝脓肿的外科治疗。

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BACKGROUND AND AIM: Although Pyogenic Liver Abscess (PLA) has lower mortality rate in recent years due to the broad spectrum antibiotic usage, developed imaging techniques and improved intensive care services, it is still a potentially fatal disease. The objective of this study is to examine the treatment methods and our case load with the current literature. MATERIALS AND METHODS: Of 55 patients with PLA, between January 2000 and December 2009, records of 28 who received surgical drainage treatment have retrospectively been analysed. RESULTS: Nineteen (67.9%) of the patients were male, while 9 (32.1%) were female. Average age was 41.07 (15-76). Seven (25%) had associated disease. The most common symptoms were fever and abdominal pain. Twenty three (82.1%) patients had single and 5 (17.9%) had multiple cavitary lesion. Nineteen (67.9%) patients had abscess on the right and 7 (25%) had on the left one, while 2 (7.1%) had on both lobes. All were treated surgically, because of 11 (39.3%) inappropriate localization for percutaneous treatment, 6 (21.5%) insufficient percutaneous drainage, 6 (21.5%) intraabdominal free rupture and 5 (17.7%) multiple cavitary lesion. We observed 5 pulmonary complications, 5 wound infections and 2 perihepatic collections. The average hospital stay was 11.2 days. We observed only two deaths (7.1%). CONCLUSIONS: Surgical treatment is the sole option for the patients with PLA who; (a) can't be treated by percutaneous drainage or had an unsuccessful one, (b) have multiple abscess cavity, (c) are thought to have perforated abscess, (d) have additional abdominal pathology requiring laparatomy.
机译:背景与目的:尽管近年来化脓性肝脓肿(PLA)由于使用了广谱抗生素,开发了成像技术和改善了重症监护服务而降低了死亡率,但它仍然是潜在的致命疾病。这项研究的目的是根据当前文献来研究治疗方法和我们的病案负担。材料与方法:回顾性分析了2000年1月至2009年12月的55例PLA患者中的28例接受外科引流治疗的记录。结果:十九名患者(67.9%)为男性,而九名患者(32.1%)为女性。平均年龄为41.07(15-76)。七名(25%)有相关疾病。最常见的症状是发烧和腹痛。 23例(82.1%)患者为单发,5例(17.9%)为多发性空洞病变。右侧有19例(67.9%)脓肿,左侧有7例(25%),两个肺叶都有2例(7.1%)。由于11例(39.3%)不适当地进行经皮治疗,6例(21.5%)的经皮引流不充分,6例(21.5%)的腹腔内游离破裂和5例(17.7%)的多发性空洞病变,所有患者均接受了手术治疗。我们观察到5例肺部并发症,5例伤口感染和2例肝周集合。平均住院时间为11.2天。我们仅观察到两人死亡(7.1%)。结论:外科治疗是PLA患者的唯一选择。 (a)不能经皮引流治疗或失败,(b)有多个脓肿腔,(c)被认为有穿孔脓肿,(d)有需要开腹手术的其他腹部病理。

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