Analysis Of The Clinical And Etiological Characteristics Of Pyogenic Liver Abscess And The Influencing Factors Of Treatment Effect

Background The incidence of pyogenic liver abscess has been increasing in recent years,and when infection is poorly controlled,it can lead to sepsis,multiple organ dysfunction,and death.Objective To identify the clinical and etiological characteristics of pyogenic liver abscess,the influencing factors associated with the treatment effect of pyogenic liver abscess and to establish therapeutic effect model.Methods A total of 210 patients with pyogenic liver abscess admitted to Yichang Central People’s Hospital from January 2015 to August 2020 were selected as the research subjects,throughing SPSS 25.0 statistical software to analyze the clinical and etiology characteristics of pyogenic liver abscess and the factors influencing the treatment effect,establishing a prediction model for assessing treatment effect pyogenic liver abscess.Results（1）Pyogenic liver abscess etiology and clinical features analysis:a total of 210cases were collected,male 127 cases,female 83 cases,the average age was（58.9±14.3）years old.hypertension,diabetes and biliary benign disease or surgery were the three major risk factors.Liver abscesses were mostly located in the right lobe of liver,single,thin wall,and mostly liquefied.Klebsiella pneumoniae was the most common pathogen,followed by Escherichia coli.（2）Clinical characteristics analysis of Klebsiella pneumoniae liver abscess and non-Klebsiella pneumoniae liver abscess:diabetes mellitus was the most common complication in Klebsiella pneumoniae liver abscess patients.the mean C-reactive protein and fibrinogen values in patients with Klebsiella pneumoniae liver abscess[（180.6±86.6）mg/L,（6.3±1.8）g/L]were higher than those in patients with non-Klebsiella pneumoniae liver abscess[（138.7±75.8）mg/L,（5.6±1.5）g/L]（P<0.05）.（3）Analysis of the characteristics of different treatment methods for pyogenic liver abscess:the white blood cell count,neutrophils count,alanine aminotransferase and C-reactive protein increased more significantly in the combination group,while the hemoglobin and albumin decreased more significantly（P<0.05）;The abscesses in the combined group were larger,A higher proportion of patients in the combination group responded well to treatment（P<0.05）.（4）Analysis of influencing factors of treatment effect of pyogenic liver abscess and establishment and evaluation of prediction model of treatment effect:C-reactive protein and liver abscess size were independent risk factors for the treatment effect of bacterial liver abscess（P<0.05）.The prediction model was P=1/(1+e^-y),Y=-2.919+0.006×C-reactive protein+0.139×abscess size,where P was the probability of poor treatment response and Y was the prediction index.The results showed that the specificity,sensitivity,positive predictive value and negative predictive value of the model were 70%,84.91%,93.75%and 46.67%,and the total accuracy was 82.54%.Conclusion（1）Hypertension,diabetes and benign disease of biliary system or surgery were the three major risk factors.Klebsiella pneumoniae was the main pathogen,followed by Escherichia coli.（2）C-reactive protein and fibrinogen have certain value in the diagnosis of Klebsiella pneumoniae liver abscess.（3）The independent influencing factors for the treatment effect of pyogenic liver abscess were C-reactive protein and abscess size.The prediction model P=1/(1+e^-y),Y=-2.919+0.006×C-reactive protein+0.139×abscess size could predict the treatment effect of pyogenic liver abscess.