刘波 1丁炎 1王爱花 2周群燕 3邬匡杰 4程海燕5
作者信息
- 1. 214023 江苏省无锡市，南京医科大学附属无锡人民医院超声医学科
- 2. 214023 江苏省无锡市，南京医科大学附属无锡人民医院医学影像科
- 3. 214023 江苏省无锡市，南京医科大学附属无锡人民医院消化内科
- 4. 214023 江苏省无锡市，南京医科大学附属无锡人民医院肝胆外科
- 5. 214023 江苏省无锡市，南京医科大学附属无锡人民医院内分泌科
- 折叠
摘要
Abstract
Objective To discuss the clinical and imaging features of patients with bacterial liver abscess caused by Klebsiella pneumoniae liver abscesses( KPLA)in diabetics at different levels of glycosylated hemoglobin( HbA1c )control. Methods A total of 146 patients with diabetes combined with KPLA admitted in Wuxi People′s Hospital of NanJing Medical University from January 2008 to September 2015 were selected. According to the levels of HbA1c ,they were divided into three groups,namely group A including 31 patients with good control of HbA1c level,HbA1c≤ 7. 0% ;group B including 52 patients with relatively control of HbA1c level,7. 0% < HbA1c≤ 9. 0% ;and group C including 63 patients with poor control of HbA1c level,HbA1c > 9. 0% . The basic information,underlying diseases,signs and symptoms,imaging features before abscess drainage,complications,abscess metastasis,treatment and prognosis of the patients in 3 groups were collected and compared. Results The time of hospital stay of patients in group B was longer than that in group A(P < 0. 05). The age of patients in group C was younger than that in group A and group B,the time of hospital stay of patients in group C was longer than that in group A and group B(P < 0. 05). The incidence of hyperlipidaemia,chronic renal failure,pneumatosis of biliary system by ultrasonic,pneumatosis of vomica exaimined and pleural thickening by CT,pleural effusion of patients in group B were higher than those in group A(P < 0. 01). The incidence of hyperlipidaemia,chronic renal failure,pneumatosis of biliary system by ultrasonic,pneumatosis of vomica exaimined and pleural thickening by CT,pleural effusion,subphrenic abscesses of patients in group C were higher than those in group A and group B(P < 0. 01). All patients received the ultrasound guided percutaneous catheter drainage for liver abscess after their admission. One case of patient in group C died of systemic multiple infection complicated by organ failure. The rest patients had recovered and been discharged from hospital. Conclusion Patients with diabetes complicated by KPLA and with poor control of HbA1c level have young and longer time in hospitalization,higher incidence of hyperlipemia and chronic renal failure. The imaging features shows the high incidence of pneumatosis of biliary system by ultrasonic,pneumatosis of vomica exaimined and pleural thickening by CT,as well as higher incidence of pleural effusion, subphrenic abscesses. Patients with severe illness may die and they should be thought highly of and prevented from diseases with poor prognosis.关键词
糖尿病/肝脓肿/肺炎克雷伯菌/血红蛋白 A,糖基化Key words
Diabetes mellitus/Liver abscess/Klebsiella pneumoniae/Hemoglobin A,glycosylated分类
医药卫生
