肝脏 ›› 2024, Vol. 29 ›› Issue (8): 994-997.

• 其他肝病 • 上一篇    下一篇

糖尿病合并侵袭性肺炎克雷伯菌肝脓肿综合征17例诊治体会

姜莹, 杨欢, 郑逸佳, 涂艳芳, 黄燕玉, 高海兵, 郑瑞丹   

  1. 363000 福建 漳州正兴医院感染性疾病科(姜莹,郑逸佳,涂艳芳,郑瑞丹) 护理部(杨欢,黄燕玉);福建医科大学孟超医院肝内科(高海兵)
  • 收稿日期:2023-11-30 出版日期:2024-08-31 发布日期:2024-09-30
  • 通讯作者: 杨欢,Email:zhengruidan175@sina.cn
  • 基金资助:
    福建省自然科学基金项目(面上)(2021J011289)

Diagnosis and treatment of Klebsiella pneumoniae liver abscesses in 17 diabetic patients

JIANG Ying, YANG Huan, ZHENG Yi-jia, TU Yan-fang, HUANG Yan-yu, GAO Hai-bing, ZHENG Rui-dan   

  1. Department of Infectious Diseases,Zhangzhou Zhengxing Hospital,Fujian 363000,China
  • Received:2023-11-30 Online:2024-08-31 Published:2024-09-30
  • Contact: YANG Huan,Email:zhengruidan175@sina.cn

摘要: 目的 探讨糖尿病合并侵袭性肺炎克雷伯菌肝脓肿综合征患者的诊治体会。方法 选取2017—2023年漳州正兴医院收治糖尿病合并肝脓肿综合征患者17例,均表现出相关炎症指标升高、肺部影像学异常、血糖控制欠佳,脓液或血液培养均培养出肺炎克雷伯菌,通过监测生命征、肝脓肿穿刺引流、抗生素使用、控制血糖及营养支持改善预后。结果 糖尿病合并侵袭性肺炎克雷伯菌肝脓肿综合征患者经肝脓肿穿刺引流、控制血糖、选用合理抗生素等综合治理后炎症指标恢复正常,血糖控制良好,术后无并发症发生,血培养未检测出病原菌。结论 在治疗糖尿病合并侵袭性肺炎克雷伯菌肝脓肿综合征的过程中,需要临床对于血糖监测、肝脓肿穿刺引流、抗生素的合理使用、生命营养支持、日常护理等提出更高的要求。

关键词: 肝脓肿, 肺炎克雷伯菌, 糖尿病

Abstract: Objective To investigate the clinical features and summarize the key aspects of diagnosis and treatment in diabetic patients with invasive Klebsiella pneumoniae liver abscess syndrome. Methods From 2017 to 2023, 17 diabetic patients with liver abscess syndrome were selected. All patients exhibited elevated inflammatory markers, abnormal lung imaging, poor blood glucose control, and Klebsiella pneumoniae was identified in pus or blood culture. Prognosis improved through monitoring vital signs, liver abscess puncture and drainage, antibiotic therapy, blood glucose control, and nutritional support. Results In diabetic patients with invasive Klebsiella pneumoniae liver abscess syndrome, comprehensive treatment-including liver abscess puncture and drainage, blood glucose control, and appropriate antibiotic therapy-resulted in normalization of inflammatory markers, effective blood glucose management, absence of postoperative complications , and no detection of pathogenic bacteria in blood culture. Conclusion In the treatment of diabetic patients with invasive Klebsiella pneumoniae liver abscess syndrome, rigorous clinical standards should be established for blood glucose monitoring, liver abscess puncture and drainage, rational antibiotic use, nutritional support, and daily care.

Key words: Liver abscess, Klebsiella pneumoniae, Diabetes