文章摘要
隐源性细菌性肝脓肿置管引流联合抗菌药物治疗的影响因素
Analysis of risk factors for the efficacy of catheter drainage combined with antibiotic therapy in patients with bacterial liver abscesses of unknown origin
投稿时间:2025-07-25  
DOI:10.3969/j.issn.1000-0399.2026.05.009
中文关键词: 细菌性肝脓肿  隐源性  置管引流  治疗  影响因素
英文关键词: Bacterial liver abscess  Idiopathic  Tube drainage  Treatment  Influencing factors
基金项目:
作者单位
李志贵 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
詹先锋 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
杨耀鑫 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
吴鹏飞 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
季月辉 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
朱锋 241000 安徽芜湖 芜湖市第一人民医院肝胆胰外科 
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中文摘要:
      目的 探讨影响隐源性细菌性肝脓肿(PLAC)置管引流联合抗菌药物治疗的影响因素。方法 回顾性分析2021年3月至2025年3月芜湖市第一人民医院因患PLAC住院行局部脓肿置管引流联合抗菌药物治疗的160例患者病历资料,根据住院30 d内治疗结局情况分为观察组(未治愈,45例)和对照组(治愈,115例),通过单因素、多元logistic回归模型判断影响因素,绘制受试者工作特征(ROC)曲线评估预测效能。结果 寒战、发热为两组最常见症状。观察组出现呼吸困难、咳嗽、谵妄等重型脓毒症相关症状的比例高于对照组(P<0.05)。多元logistic回归模型显示,局部脓肿特征(脓肿分隔、脓液性质、脓肿直径)、综合临床特征(年龄)均是这类患者的独立影响因素(P<0.05)。ROC曲线结果显示,年龄、脓肿分隔、脓液性质、脓肿直径预测隐源性细菌性肝脓肿置管引流联合抗菌药物治疗的曲线下面积(AUC)分别为0.818、0.728、0.595和0.844。4者联合预测的AUC为0.979,灵敏度、特异度分别为0.889、0.957。结论 年龄、脓肿分隔、黏稠型脓液、脓肿直径、脓液是PLAC置管引流联合抗菌药物治疗的影响因素,以上指标联合预测这类患者的效能更好。
英文摘要:
      Objective To investigate the factors influencing the outcomes of catheter drainage combined with antimicrobial therapy for patients with primary liver abscess of unknown origin(PLAC). Methods A retrospective analysis was conducted on the medical records of 160 patients admitted to the First People's Hospital of Wuhu from March 2021 to March 2025 for treatment of PLAC, who underwent local abscess catheterization and drainage combined with antimicrobial therapy. Based on treatment outcomes within 30 days of admission, the patients were divided into an observation group(45 cases, not cured) and a control group(115 cases, cured). Univariate and multivariate logistic regression models were used to identify influencing factors, and receiver operating characteristic(ROC) curves were plotted to evaluate predictive performance. Results Chills and fever were the most common symptoms in both groups. The proportion of patients in the observation group exhibiting severe sepsis-related symptoms, such as dyspnea, cough, and delirium, was higher than that in the control group(P<0.05). Multivariate logistic regression analysis revealed that local abscess characteristics(abscess compartmentalization, pus characteristics, and abscess diameter) and comprehensive clinical characteristics(age) were all independent predictors of treatment efficacy(P<0.05). Receiver operating characteristic(ROC) curve results showed that the area under the curve(AUC) for predicting the 30-day efficacy of PLAC catheter drainage combined with antimicrobial therapy was 0.818, 0.728, 0.595, and 0.844 for age, abscess compartmentalization, pus characteristics, and abscess diameter, respectively. The combined AUC for these four factors was 0.979, with sensitivity and specificity of 0.889 and 0.957, respectively. Conclusion Age, abscess compartmentalization, viscous pus, abscess diameter, and pus are identified as factors influencing the 30-day efficacy of PLAC catheter drainage combined with antimicrobial therapy. All of these factors demonstrated some predictive value for the 30-day efficacy of this treatment regimen, with the combined data showing superior predictive performance.
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