实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 137-140.doi: 10.3969/j.issn.1672-5069.2026.01.035

• 肝脓肿 • 上一篇    下一篇

90例细菌性肝脓肿患者临床特征及抗菌药物应用分析*

邱瑶雪, 孙银春, 陈诚, 秦雅群, 许淑君, 查翔远   

  1. 211100 南京市 南京医科大学附属江宁医院感染病科
  • 收稿日期:2025-09-20 出版日期:2026-01-10 发布日期:2026-02-04
  • 通讯作者: 查翔远,E-mail:djq2425@sina.com
  • 作者简介:邱瑶雪,女,33岁,医学硕士,主治医师。E-mail:17701598671@163.com
  • 基金资助:
    *江苏省南京市卫健委卫生科技发展计划项目(编号:YKK23228)

Clinical feature and antibiotic application in patients with bacterial liver abscess: An analysis of 90 cases

Qiu Yaoxue, Sun Yinchun, Chen Cheng, et al   

  1. Department of Infectious Diseases, Jiangning Hospital Affiliated of Nanjing Medical University, Nanjing 211100, Jiangsu Province, China
  • Received:2025-09-20 Online:2026-01-10 Published:2026-02-04

摘要: 目的 分析总结一组细菌性肝脓肿(BLA)患者的临床特征及抗菌药物应用情况。方法 2020年5月~2025年5月我院收治的90例BLA患者,行穿刺抽脓和静脉应用抗生素治疗,常规行细菌鉴定和药敏实验。结果 本组患者男:女之比为2.1:1,平均年龄60.5±7.4岁;存在2型糖尿病占45.5%,胆石症占35.6%,高血压占32.2%,结肠和肺恶性肿瘤占5.6%;外周血白细胞计数为(12.0±1.3)×109/L,血清CRP水平(69.4±5.1)mg/L,PCT水平为(2.4±0.2)ng/mL,血清白蛋白(ALB)水平为(31.5±9.6)g/L;单发脓肿占74.4%,多发占25.6%;肝右叶脓肿占77.8%,左叶占11.1%,左右叶占11.1%;脓肿直径为(6.8±1.1)cm;细菌培养阳性率为80.0%,共分离出细菌78株,其中肺炎克雷伯菌阳性74例;对头孢哌酮/舒巴坦等9种抗生素敏感率为100.0%;初始经验应用β-内酰胺/酶抑制剂占32.2%,后续依据药敏实验结果调整用药;治疗13~25 (17.8±2.5)d,治愈率为94.4%,好转4例(4.4%),死亡1例(1.1%)。结论 BLA好发于中老年男性,有糖尿病等基础疾病者多发,肺炎克雷伯菌为主要病原菌。经验应用广覆盖抗生素和穿刺抽脓治疗有效。

关键词: 细菌性肝脓肿, 临床特征, 病原菌, 肺炎克雷伯菌, 抗生素, 预后

Abstract: Objective The aim of this study was to summarize clinical feature and antibiotic application in a series of patients with bacterial liver abscess (BLA). Methods A total of consecutive 90 patients with BLA were encountered in our hospital between May 2020 and May 2025, and all underwent puncture drainage and intravenous antibiotic administration. Bacteria separation, characterization and drug sensitivity tests were routinely performed. Results Male to female ratio in our series was 2.1:1, with mean age range of 60.5±7.4 yr; underlying diabetes accounted for 45.5%, cholelithiasis for 35.6%, hypertension for 32.2%, malignant tumors for 5.6%; white blood cell count was (12.0±1.3)×109/L, serum C-reactive protein level was (69.4±5.1)mg/L, serum procalcitonin level was (2.4±0.2)ng/mL, and serum albumin level was(31.5±9.6)g/L; single abscess accounted for 74.4% and multiple for 25.6%; abscess at right lobe accounted for 77.8%, at left for 11.1% and both for 11.1%; diameter of abscess was (6.8±1.1)cm; prevalence of positive bacteria was 80.0%, with 78 strains of pathogens characterized, of which, Klebsiella pneumoniae positive in 74 cases; 100.0% sensitivity to 9 antibiotics, including cefoperazone/sulbactam; initial empirical treatment with β-lactam/enzyme inhibitor accounted for 32.2% and antimicrobial therapy switched to sensitive medicines based on drug sensitivity tests; after 13 to 25 (17.8±2.5)d treatment, the recovery rate was 94.4%, effective rate was 4.4% and one patient (1.1%)died of multiple organ failure. Conclusion The incidence of BLA is higher in middle-aged and elderly males, and most of them have underlying chronic disease. The common pathogen is Klebsiella pneumoniae, and the outcomes is satisfactory in most cases with appropriate management.

Key words: Bacterial liver abscess, Clinical ferature, Pathogens, Klebsiella pneumoniae, Antibiotic, Prognosis