| Abstract |
Objective Purulent liver abscess is a life-threatening disease, often accompanied by chronic diseases or risk factors. This paper retrospectively analyzed the clinical characteristics of 36 cases diagnosed with suppurative liver abscess, and compared the clinical characteristics of diabetic and non-diabetic patients with liver abscess. The differences in characteristics are expected to provide a basis for clinical management. Methods The general and clinical data of 44 patients with PLA who were hospitalized in our hospital in September 2016 and 2021 were collected and divided into two groups according to whether the patients were accompanied by diabetes. The statistical clinical data included: demographic characteristics, underlying diseases, clinical Manifestations, laboratory examinations, imaging examinations, concomitant diseases, treatment methods, length of hospital stay, etc. Results Finally, 36 patients were included in this study, with a male to female ratio of 25/11 and an average age of (63.92±13.05) years. Among them, there were 20 cases in the diabetes group, the ratio of male to female in the diabetes group was 15/5, and the average age was (62.2±14.12) years; there were 16 cases in the non-diabetic group, and the ratio of male to female in the non-diabetic group was 10/6, and the average age was ( 66.06±11.58) years old; there was no significant difference in age and gender between the two groups. In the comparison of past medical history, clinical symptoms and concomitant diseases between the two groups, the history of abdominal surgery between the two groups (Pabdominal surgery=0.049), the history of other chronic diseases (χchronic disease history 2=10.89, P history of chronic diseases) = 0.002) and with or without pulmonary infection (χ pulmonary infection 2 = 5.63, P pulmonary infection = 0.03); white blood cell count, neutrophil count, platelet count, C-reactive protein between the two groups There was no significant difference in blood sugar and glycosylated hemoglobin between the two groups (PHbA1c<0.001; PGlu<0.001); serum albumin, alkaline phosphatase, alanine aminotransferase between the two groups , aspartate aminotransferase, glutamyl transpeptidase, total bilirubin, direct bilirubin, indirect bilirubin, urea ammonia and creatinine had no significant difference; uric acid (PUA=0.01), There was a significant difference in uric acid/creatinine (tUA/Cr=2.77, PUA/Cr=0.009); there was a significant difference in whether the two groups were infected with Klebsiella pneumoniae (χ Klebsiella pneumoniae 2=5.14, P Klebsiella pneumoniae = 0.04); the location of liver abscesses in both groups was in the right lobe of the liver, of which 1 case was multiple in the non-diabetic group, and 4 cases were multiple in the diabetic group, but there was no statistical difference between the two groups. There was no statistical difference in the composition ratio of abscess size between the two groups (P size = 0.89); 14 patients (70%) in the diabetes group had an undetermined admission diagnosis and were not admitted to specialist diagnosis and treatment and delayed treatment, and in the non-diabetic group 5 cases (31.23%) had the above situation, and there was a significant difference between the two groups (χ delay 2=5.14, P delay=0.02); the average length of hospital stay in the diabetic group was (16.75±3.54) days, and the length of hospital stay in the non-diabetic group was (16.75±3.54) days. (13.31±4.39) days, there was a significant difference in hospital days between the two groups (t hospital days = 2.60, P hospital days = 0.014). Conclusion The clinical symptoms and signs of diabetic patients with liver abscess are not specific, but they are often accompanied by pulmonary infection, and have less history of abdominal surgery. The inflammatory indicators, liver function and imaging tests are not specific; uric acid and uric acid/uric acid/ Changes in creatinine are more sensitive than changes in other inflammatory markers in patients with diabetic liver abscess; patients with diabetic liver abscess are more likely to be infected with Klebsiella pneumoniae, which may be related to poor glycemic control; patients with diabetes and liver abscess are more prone to delayed and longer hospital stays.
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