关键词: 肝脓肿, 脓毒症, 多器官功能障碍

Abstract:

Diagnosis and treatment of fulminant liver abscess：A report of 12 cases        YIN Da-long，LIU Lian-xin，JIANG Hong-chi. Department of Hepatic Surgery，the First Affiliated Hospital of Harbin Medical University；Key Laboratory of Hepatosplenic Surgery（Ministry of Education），Harbin150001，China
Corresponding author：LIU Lian-xin，E-mail：liulianxin@medmail.com.cn
Abstract    Objective    To investigate the characteristics，clinical manifestations and prognosis of fulminant liver abscess (FLA)，provide useful references for its diagnosis and treatment. Methods    The clinical characteristics，laboratory tests，imaging studies and treatment of 12 cases of FLA in 500 consecutive cases of liver abscess admitted from January 2007 to December 2014 in the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively. Results    The incidence of FLA was 2.4% with first misdiagnosis rate of 67%，and the mortality rate was 25%. Fever，abdominal pain and jaundice were the most common clinical manifestations，accompanied by multiple organ dysfunction syndrome (firstly respiratory system dysfunction). Half of cases of FLA have diabetes，and 91.7% of the pathogen were Klebsiellapneumoniae. Support treatment was employed in the first phase due to insufficient liquefaction abscesses and percutaneous drainage guided by ultrasound in the second stage as soon as possible. Conclusion    FLA has the characteristics of overwhelming progress，high first misdiagnosis rate, high complication incidence and high mortality. Klebsiellapneumoniae is the main pathogen of FLA and percutaneous drainage guided by ultrasound should be employed as soon as possible.

Key words: liver abscess, sepsis, multiple organ dysfunction syndrome