恶性肿瘤相关肝脓肿患者的临床特征分析
目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结，早期判断病情进展，及时有效治疗。 方法 回顾性分析2005年3月—2018年7月空军军医大学第二附属医院收治的371例肝脓肿患者的临床资料。其中34例恶性肿瘤相关肝脓肿患者作为肿瘤组，按照约1∶2比例、时间匹配的原则，随机选择非恶性肿瘤相关肝脓肿患者(n=70)作为非肿瘤组，将两组的临床特点进行比较。正态分布的计量资料两组间比较采用成组t检验；非正态分布的计量资料两组间比较采用Mann-Whitney U检验；计数资料两组间比较采用χ2检验或Fisher检验。 结果 肿瘤组中肝胆系统肿瘤22例(64.7%)，胃肠道肿瘤7例(20.6%)，非消...
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| Published in | Linchuang gandanbing zazhi Vol. 39; no. 4; pp. 850 - 855 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
Changchun
Journal of Clinical Hepatology
01.04.2023
空军军医大学第二附属医院传染科,西安710038 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 2097-3497 |
| DOI | 10.3969/j.issn.1001-5256.2023.04.016 |
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| Abstract | 目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结，早期判断病情进展，及时有效治疗。 方法 回顾性分析2005年3月—2018年7月空军军医大学第二附属医院收治的371例肝脓肿患者的临床资料。其中34例恶性肿瘤相关肝脓肿患者作为肿瘤组，按照约1∶2比例、时间匹配的原则，随机选择非恶性肿瘤相关肝脓肿患者(n=70)作为非肿瘤组，将两组的临床特点进行比较。正态分布的计量资料两组间比较采用成组t检验；非正态分布的计量资料两组间比较采用Mann-Whitney U检验；计数资料两组间比较采用χ2检验或Fisher检验。 结果 肿瘤组中肝胆系统肿瘤22例(64.7%)，胃肠道肿瘤7例(20.6%)，非消化道肿瘤5例(14.7%)。肿瘤组合并腹部手术史及肝硬化比例(44.1%、26.5%)高于较非肿瘤组(7.1%、7.1%)(χ2值分别为20.142、7.338，P值均＜0.05)；入院急性生理与慢性健康评分＞16分患者比例高于非肿瘤组(44.1% vs 15.7%, χ2=9.846，P=0.002)。肿瘤组白蛋白低于非肿瘤组[(27.2±5.2) g/L vs (30.8±2.6) g/L， t=-3.131，P=0.002]，而总胆红素显著高于非肿瘤组[54(13~313) μmol/L vs 33(7~96) μmol/L, U=1 816.0，P＜0.001]。肿瘤组以大肠埃希菌为主(23.5%)，非肿瘤组以肺炎克雷伯菌为主(27.1%)，前者两种以上细菌感染更为多见(11.8% vs 2.8%)。影像学提示肿瘤组多发脓肿更为多见(47.1% vs 24.3%，χ2=5.479，P=0.019)。与非肿瘤组相比，肿瘤组平均住院天数长(U=1 728.5，P＜0.001)、治疗失败率高(P=0.005)。 结论 恶性肿瘤相关肝脓肿多合并肝胆肿瘤，致病菌以大肠埃希菌为主，多部位脓肿较常见，预后较差。临床应选择合适抗生素，联合穿刺引流，针对高危人群，必要时可降低手术干预门槛，降低病死率。 |
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| AbstractList | 目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结，早期判断病情进展，及时有效治疗。 方法 回顾性分析2005年3月—2018年7月空军军医大学第二附属医院收治的371例肝脓肿患者的临床资料。其中34例恶性肿瘤相关肝脓肿患者作为肿瘤组，按照约1∶2比例、时间匹配的原则，随机选择非恶性肿瘤相关肝脓肿患者(n=70)作为非肿瘤组，将两组的临床特点进行比较。正态分布的计量资料两组间比较采用成组t检验；非正态分布的计量资料两组间比较采用Mann-Whitney U检验；计数资料两组间比较采用χ2检验或Fisher检验。 结果 肿瘤组中肝胆系统肿瘤22例(64.7%)，胃肠道肿瘤7例(20.6%)，非消化道肿瘤5例(14.7%)。肿瘤组合并腹部手术史及肝硬化比例(44.1%、26.5%)高于较非肿瘤组(7.1%、7.1%)(χ2值分别为20.142、7.338，P值均＜0.05)；入院急性生理与慢性健康评分＞16分患者比例高于非肿瘤组(44.1% vs 15.7%, χ2=9.846，P=0.002)。肿瘤组白蛋白低于非肿瘤组[(27.2±5.2) g/L vs (30.8±2.6) g/L， t=-3.131，P=0.002]，而总胆红素显著高于非肿瘤组[54(13~313) μmol/L vs 33(7~96) μmol/L, U=1 816.0，P＜0.001]。肿瘤组以大肠埃希菌为主(23.5%)，非肿瘤组以肺炎克雷伯菌为主(27.1%)，前者两种以上细菌感染更为多见(11.8% vs 2.8%)。影像学提示肿瘤组多发脓肿更为多见(47.1% vs 24.3%，χ2=5.479，P=0.019)。与非肿瘤组相比，肿瘤组平均住院天数长(U=1 728.5，P＜0.001)、治疗失败率高(P=0.005)。 结论 恶性肿瘤相关肝脓肿多合并肝胆肿瘤，致病菌以大肠埃希菌为主，多部位脓肿较常见，预后较差。临床应选择合适抗生素，联合穿刺引流，针对高危人群，必要时可降低手术干预门槛，降低病死率。 目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结,早期判断病情进展,及时有效治疗.方法 回顾性分析2005年3月—2018年7月空军军医大学第二附属医院收治的371例肝脓肿患者的临床资料.其中34例恶性肿瘤相关肝脓肿患者作为肿瘤组,按照约1:2比例、时间匹配的原则,随机选择非恶性肿瘤相关肝脓肿患者(n=70)作为非肿瘤组,将两组的临床特点进行比较.正态分布的计量资料两组间比较采用成组t检验;非正态分布的计量资料两组间比较采用Mann-Whitney U检验;计数资料两组间比较采用χ2检验或Fisher检验.结果 肿瘤组中肝胆系统肿瘤22例(64.7％),胃肠道肿瘤7例(20.6％),非消化道肿瘤5例(14.7％).肿瘤组合并腹部手术史及肝硬化比例(44.1％、26.5％)高于较非肿瘤组(7.1％、7.1％)(χ2值分别为20.142、7.338,P值均<0.05);入院急性生理与慢性健康评分>16分患者比例高于非肿瘤组(44.1％vs 15.7％,χ2=9.846,P=0.002).肿瘤组白蛋白低于非肿瘤组[(27.2±5.2)g/L vs(30.8±2.6)g/L,t=-3.131,P=0.002],而总胆红素显著高于非肿瘤组[54(13～313)μmol/L vs 33(7～96)μmol/L,U=1816.0,P<0.001].肿瘤组以大肠埃希菌为主(23.5％),非肿瘤组以肺炎克雷伯菌为主(27.1％),前者两种以上细菌感染更为多见(11.8％vs 2.8％).影像学提示肿瘤组多发脓肿更为多见(47.1％vs 24.3％,χ2=5.479,P=0.019).与非肿瘤组相比,肿瘤组平均住院天数长(U=1728.5,P<0.001)、治疗失败率高(P=0.005).结论 恶性肿瘤相关肝脓肿多合并肝胆肿瘤,致病菌以大肠埃希菌为主,多部位脓肿较常见,预后较差.临床应选择合适抗生素,联合穿刺引流,针对高危人群,必要时可降低手术干预门槛,降低病死率. |
| Author | 张野 张谷芬 姚娜 毕铭辕 康文 连建奇 汪春付 王临旭 |
| AuthorAffiliation | 空军军医大学第二附属医院传染科,西安710038 |
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| Author_FL | BI Mingyuan KANG Wen ZHANG Ye ZHANG Gufen WANG Chunfu WANG Linxu YAO Na LIAN Jianqi |
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| Author_xml | – sequence: 1 fullname: 张谷芬 – sequence: 2 fullname: 姚娜 – sequence: 3 fullname: 毕铭辕 – sequence: 4 fullname: 张野 – sequence: 5 fullname: 康文 – sequence: 6 fullname: 连建奇 – sequence: 7 fullname: 王临旭 – sequence: 8 fullname: 汪春付 |
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| Keywords | 预后 肿瘤 肝脓肿 |
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| Snippet | 目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结，早期判断病情进展，及时有效治疗。 方法... 目的 对恶性肿瘤相关肝脓肿的临床特点进行分析和总结,早期判断病情进展,及时有效治疗.方法... |
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| SubjectTerms | Abscesses E coli Pathogens |
| Title | 恶性肿瘤相关肝脓肿患者的临床特征分析 |
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