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首页> 外文期刊>World Journal of Gastroenterology >Clinical characteristics and prognostic factors of splenic abscess: a review of 67 cases in a single medical center of Taiwan.
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Clinical characteristics and prognostic factors of splenic abscess: a review of 67 cases in a single medical center of Taiwan.

机译：脾脓肿的临床特征和预后因素：台湾一所医疗中心对67例病例的回顾。

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摘要

AIM: To analyze 67 cases of splenic abscess in a medical center of Taiwan during a period of 19 years. METHODS: From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, APACHE II scores, and mortality rates were analyzed. RESULTS: There were 41 males and 26 females with the mean age of 54.1+/-14.1 years. Multiple splenic abscesses (MSA) account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixty-seven patients (35.8%) had extrasplenic abscesses, with leading site of liver (34.6%). Microbiological cultures were positive in 58 patients (86.6%), with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus (GNB) infection predominated (55.2%), with leading pathogen of Klebsiella pneumoniae (22.4%), followed by gram positive coccus (GPC) infection (31%). Splenectomy was performed in 26 patients (38.8%), percutaneous drainage or aspiration in 21 (31.3%), and antibiotic therapy alone in 20 patients (29.9%). Eventually, 12 of 67 patients expired (17.9 %). By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC (P=0.036). Patients with GNB infection (P=0.009) and multiple abscesses (P=0.011) experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE II score of 12 expired patients (16.3+/-3.2) was significantly higher than that of the 55 survivals (7.2+/-3.8) (P<0.001). CONCLUSION: MSA, GNB infection, and high APACHE II scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.
机译：目的：分析台湾医学中心19年间的67例脾脏脓肿的病例。方法：自1986年1月至2004年12月，共纳入67例脾脓肿患者进行回顾性研究。分析了临床特征，潜在疾病，生物谱，治疗方法，APACHE II评分和死亡率。结果：男性41例，女性26例，平均年龄为54.1 +/- 14.1岁。多发性脾脓肿（MSA）占28.4％，孤立性脾脓肿占71.6％。 67例患者中有26例（35.8％）患有脾外脓肿，其中以肝脏为首发部位（34.6％）。微生物培养阳性58例（86.6％），血液培养阳性71.8％，脓肿培养93.5％。革兰氏阴性杆菌（GNB）感染占主导地位（55.2％），肺炎克雷伯菌的主要病原体（22.4％），其次是革兰氏阳性球菌（GPC）感染（31％）。脾切除术26例（38.8％），经皮引流或抽吸术21例（31.3％），仅抗生素治疗20例（29.9％）。最终，67名患者中有12名患者死亡（17.9％）。据统计，与GPC感染相比，GNB感染的脾脏可能会出现多处脓肿（P = 0.036）。 GNB感染（P = 0.009）和多发脓肿（P = 0.011）的患者死亡率高于GPC感染和单发脓肿。 12名死亡患者的平均APACHE II评分（16.3 +/- 3.2）显着高于55名存活者的平均APACHE II评分（7.2 +/- 3.8）（P <0.001）。结论：MSA，GNB感染和高APACHE II评分是不良的预后因素。当存在这些危险因素时，应鼓励早期手术干预。

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