Clinical Characteristics And Prognosis Analysis Of Bacterial Liver Abscess

Objective:To retrospectively analyze the clinical characteristics and risk factors of patients with bacterial liver abscess and to provide the basis for treatment and prevention.Methods:From January 2016 to April 2018,a total of 262 untreated bacterial liver abscess patients admitted to the First Affiliated Hospital,School of Medicine,Zhejiang University were selected.The general data,basic diseases,clinical manifestations,laboratory indicators,etiological data,imaging materials,complications,treatment methods and prognosis of patients were collected and summarized.The prognosis was divided into significant group,effective group and ineffective group,and the risk factors affecting the prognosis were discussed by orderly multiclassification logistic regression analysis.Results:A total of 262 patients with bacterial liver abscess were included in this study.There were 169 males(64.5%)and 93 females(35.5%),with an average age of 59.34±13.68 years old,and the number of patients aged 60-69 years old was the most,with a total of 86 cases(32.82%).The most common clinical manifestations were fever(97.33%),colds(58.4%)and chills(41.60%),followed by abdominal pain(34.35%)and poor appetite(32.44%).The physical signs were tenderness or knocking pain in the liver area(21.37%).The most common underlying diseases were diabetes(97 cases,37.02%)and biliary diseases(95 cases,36.26%).Pleural effusion(40.46%),hypoproteinemia(40.08%)and pneumonia(35.11%)were the commonest complications.Klebsiella pneumoniae is the most common pathogen isolated from pus culture(80.52%)and blood culture(80.00%),sensitive to most antibiotics and completely resistant to ampicillin.In the aspect of imaging,single abscess in the right lobe of the liver(56.87%),unclear boundary(84.73%)and solid appearance(53.44%)were most common,with visible gas(6.87%)and sepsis space(35.11%).The average diameter of the abscess was 7.03±2.37cm.Among the five treatment methods,the clinical application of antibiotics combined with percutaneous drainage for hepatic abscess was the most popular treatment methods,accounting for 43.89%(115/262).In the study,there were 107 cases(40.84%)with significant efficacy,132 cases(50.38%)with effective efficacy,and 23 cases(8.78%)with ineffective efficacy after one month of treatment.The overall 1-month mortality rate was 1.15%,According to logistic regression analysis,the results showed that CA125,septic shock and peritonitis were the independent risk factors for poor prognosis.Conclusion:Klebsiella pneumoniae is the most common pathogen of bacterial liver abscess and is sensitive to most antibiotics.CA125,eptic shock and peritonitis were independent risk factors for poor prognosis.