Clinical Characteristics Of Pyogenic Liver Abscess In Diabetic And Non-diabetic Patients

Objective: The clinical characteristics of pyogenic liver abscess in diabetic and non-diabetic patients were compared and analyzed to provide the basis for clinical diagnosis and treatment.Methods: Retrospective study of Peking University Shenzhen Hospital between January 2014 and December 2018,five years of clinical data of 70 patients with pyogenic liver abscess,divided into two groups according to whether they had diabetes,a group of PLA with diabetes,a group was PLA without diabetes,analysis of the two groups of patients with clinical manifestation,laboratory examination,imaging examination,etiology characteristic and the result of drug susceptibility,etc.Results: The middle-aged and elderly population(?45 years old)was the population with a high incidence of PLA.The data of the two groups were not statistically significant(p > 0.05).The main clinical symptoms of PLA are fever,chills,shiver,abdominal pain.The incidence of abdominal pain is lower in PLA with DM group(P < 0.05).The white blood cell count,neutrophil percentage and neutrophil count of PLA with DM group were significantly higher than those of PLA without DM group,and the differences between the two groups were statistically significant(P < 0.05).The blood urea nitrogen and creatinine were higher and albumin were lower in the PLA with diabetes group,and the differences between the two groups were statistically significant(P < 0.05).There were no significant differences between the two groups in the location,size and quantity of abscesse(P > 0.05).In this study,Klebsiella pneumoniae was the main pathogenic bacteria in both groups.The drug resistance rate of klebsiella pneumoniae to ampicillin was 100%,that of ampicillin/sulbactam was 26.67%,and that of nitrofurantoin was 46.67%(drug resistance rate was 20.00%).It is sensitive to other antibiotics such as cephalosporin,quinolones and carbapenems.29 patients were treated with antibiotics alone,and the cure rate was 100.00%.41 patients were treated with antibiotics combined with ultrasound-guided percutaneous puncture and drainage of liver abscess,40 patients were cured with a cure rate of 97.60%.There was no statistical significance in the average length of hospital stay between the two groups.Conclusion: The onset group of PLA is mainly middle-aged and elderly people(?45years old).The main clinical symptoms of PLA are fever,chills,shiver,abdominal pain,and lack of specificity.The incidence of abdominal pain in PLA patients with diabetes is lower,which is easy to miss diagnosis in clinic.The leukocyte count,neutrophil percentage,neutrophil count,blood urea nitrogen and creatinine were higher and albumin were lower in PLA patients with diabetes.The main pathogenic bacteria of PLA is klebsiella pneumoniae,which is resistant to ampicillin,ampicillin/sulbactam and furantoin,and sensitive to ceftriazone,quinolones and carbapenems.In terms of treating,active anti-infective treat should be given,and the treatment effect is not good,can combinting with percutaneous drainage or surgical resection.