背景:肝脓肿,特别是化脓性和变形虫类型,构成重大的医疗保健挑战,尤其是在发展中国家。这些脓肿类型的准确区分和有效治疗在急诊医疗环境中至关重要。本研究旨在分析发病率,临床特征,创伤和急诊科化脓性和阿米巴性肝脓肿的治疗结果。
方法:在英迪拉·甘地医学科学研究所(IGIMS)进行,巴特那,这项为期一年的观察性研究纳入了100例诊断为肝脓肿的患者.这项研究采用了全面的方法,检查发病率,人口趋势,临床表现,治疗方式,和结果,包括复发率。
结果:该研究观察到化脓性肝脓肿的发生率更高,占病例的60%(n=60),与阿米巴肝脓肿相比,占40%(n=40)。就人口统计而言,化脓性肝脓肿在老年男性中更为普遍,平均年龄48岁,70%(n=42)的患者为男性。相比之下,阿米巴肝脓肿患者平均年龄42岁,60%(n=24)是男性。主要临床发现显示,化脓性肝脓肿病例(n=60)的白细胞计数和肝酶水平高于阿米巴肝脓肿(n=40)。治疗结果表明两种类型的肝脓肿的成功率都很高。化脓性肝脓肿的成功率为90%(n=54),而阿米巴肝脓肿的成功率略高,为95%(n=38)。然而,复发率有显著差异:化脓性肝脓肿复发率为8.3%(n=5),而阿米巴肝脓肿的复发率较低,为2.5%(n=1)。为确定治疗成功的潜在预测因素而进行的逻辑回归分析未揭示两种类型的肝脓肿的任何统计学显着因素。
结论:该研究强调了印度城市医疗保健环境中化脓性肝脓肿的发病率较高,以及根据人口统计学和临床因素预测治疗结果的复杂性。研究结果强调需要细致入微的临床方法和警惕的治疗后监测,尤其是化脓性肝脓肿。他们还强调了进一步研究以探索影响肝脓肿治疗结果的其他变量的重要性。
BACKGROUND: Liver abscesses, particularly pyogenic and amoebic types, pose a significant healthcare challenge, especially in developing countries. Accurate differentiation and effective treatment of these abscess types are crucial in emergency medical settings. This
study aims to analyze the incidence, clinical characteristics, and treatment outcomes of pyogenic and amoebic liver abscesses in a trauma and emergency department setting.
METHODS: Conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, this one-year observational
study involved 100 patients diagnosed with liver abscesses. The
study employed a comprehensive approach, examining incidence rates, demographic trends, clinical presentations, treatment modalities, and outcomes, including recurrence rates.
RESULTS: The
study observed a higher incidence of pyogenic liver abscesses, accounting for 60% of cases (n=60), compared to amoebic liver abscesses, which constituted 40% (n=40). In terms of demographics, pyogenic liver abscesses were more prevalent among older males, with the average age being 48 years, and 70% (n=42) of the patients were male. In contrast, amoebic liver abscess patients had an average age of 42 years, with 60% (n=24) being male. Key clinical findings revealed that pyogenic liver abscess cases (n=60) had higher white blood cell counts and elevated liver enzyme levels than those with amoebic liver abscesses (n=40). The treatment outcomes indicated high success rates for both types of liver abscesses. Pyogenic liver abscesses had a success rate of 90% (n=54), while amoebic liver abscesses showed a slightly higher success rate at 95% (n=38). However, there was a notable difference in recurrence rates: pyogenic liver abscesses had a recurrence rate of 8.3% (n=5), whereas amoebic liver abscesses had a lower recurrence rate of 2.5% (n=1). The logistic regression analysis conducted to identify potential predictors of treatment success did not reveal any statistically significant factors across both types of liver abscesses.
CONCLUSIONS: The
study highlights a higher incidence of pyogenic liver abscesses in an urban Indian healthcare setting and the complexity of predicting treatment outcomes based on demographic and clinical factors. The findings emphasize the need for nuanced clinical approaches and vigilant post-treatment monitoring, especially for pyogenic liver abscesses. They also underscore the importance of further research to explore additional variables influencing liver abscess treatment outcomes.