Objective:To investigate the clinical characteristics and therapeutic strategy of bacterial liver abscess in diabetics(DLA). Methods:19 cases of DLA were retrospectively reviewed. The factors which we analysed were included among the clinical presentation, the other diseases companied with DLA, the general laboratory examination, bacterial culture, the position of abscess in liver, the therapeutic methods and curative effect of treatment.Results:19 cases of DLA were all type 2 diabetes mellitus, and DLA occurred more frequently in elderly patients with hyperglycemia. Clinical features of this disorder were atypical，the occurrence of the right upper abdominal pain was not common. The positive rate of bacteria cultivation in blood, puncture fluids and other sources was lower(36.8%). The B-ultrasonography and computer tomography of liver played an important role in the diagnosis of DLA. 13 cases were treated by antibiotics along, 5 cases submitted to aspiration by the guiding of B-ultrasonography, and 1 case underwent surgical drainage of liver abscess. Among 19 cases, 18 of them were curved successfully.Conclusion:The clinical features of DLA are atypical, and also companied with many complications, which might result in the difficulty of the diagnosis of DLA. Appropriate therapeutic strategies include early diagnosis, control of hyperglycemia with insulin, sufficient use course of antibiotics and timely drainage of abscess.
报道细菌性肝脓肿感染的33.2%来源于胆道系统，本组资料有36.8%患者存在胆道感染，与之基本相符。
细菌性肝脓肿属于糖尿病感染的严重并发症，而糖尿病又是细菌性肝脓肿重要的易感因素。本组DLA患者占同期收治细菌性肝脓肿的22.1%，与文献报道的10.0%～43.3%相符Yang CC,Chen CY,Lin XZ,et al. Pyogenic liver abscess in taiwan:emphasis on gasforming liver abscess in diabetics[J].Am J Gastroenterol,1993,88(11):1911-1915.
[5]Alvarez-Perez JA,Gonzalez JJ,Baldonedo RF,et al.Clinical course, treatment and multivariate analysis of risk factors for pyogenic liver abscess[J].Am J Surg,2001,181(2):177-186.
[6]岳桂英,余云.糖尿病病人围手术期的处理[J].中国实用外科杂志,1999, 19(3):133-135.
（收稿日期：2007-11-12）
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