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題名 | Liver Abscess in Children: A Single Institutional Experience in Southern Taiwan=兒童肝膿瘍:南臺灣一醫學中心的經驗 |
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作者 | 蔡佳璋; 莊錦豪; 高常發; 柳博邁; 蘇進添; 李文杰; 梁啟迪; 黃立同; 黃崇濱; 刁茂盟; Tsai, Chia-chang; Chung, Jiin-haur; Ko, Sheung-fat; Liu, Po-mai; Su, Chin-tien; Li, Wen-chieh; Liang, Chi-di; Huang, Li-tung; Huang, Chung-bin; Tiao, Mao-meng; |
期刊 | 臺灣兒科醫學會雜誌 |
出版日期 | 20030900、20031000 |
卷期 | 44:5 民92.09-10 |
頁次 | 頁282-286+320 |
分類號 | 417.545 |
語文 | eng |
關鍵詞 | 肝膿瘍; 經皮導管引流術; 超音波; Liver abscess; Percutaneous catheter drainage; Klebsiella pneumoniae; Sonography; |
中文摘要 | 肝膿瘍於兒童期是一介很少見的疾病。自1986至2001年,十六年期間,本院共有15位病童診斷為肝膿瘍者,以其來做一回溯性的研究。其中13個病童大於八歲,2個小於1歲。發燒(15/15,100%)和腹痛(13/15,87%)是最常見的臨床徵狀。其中有十二個病人(80%),診斷前已發燒至少七天。11個病童為原因不明的肝膿瘍。於檢體中培養出病源體者,大部分來自於膿液的培養。Klebsiella pneumoniae是最常見的病源體(6/15,40%)。接受經皮導管引流的11個病童中,只有一位因臨床症狀改善不佳,而接受開刀引流治療。於本研究中所有的病童均存活。所以我們結論:在原因不明的發燒,特別是發燒至少七天的病童,若合併腹痛,一定要考慮肝膿瘍的可能性;在南台灣,大部分的兒童肝膿瘍造成原因不明;經皮導管引流合併適當的抗生素使用,對大部分的兒童肝膿瘍是有效的治療方法;而K•pneumoniae是最常見的病源體。 |
英文摘要 | Liver abscess is uncommon in children. The purpose of this study is to evaluate the predisposing factors, pathogens, duration of hospitalization, and the managements of liver abscess in children. From 1986 to 2001, fifteen children were admitted to our hospital under the diagnosis of liver abscess. Thirteen cases were older than 8 years old and two were younger than one year old. Fever (15/15, 100%) and abdominal pain (13/15, 87%) were the most common symptoms. Twelve patients (80%) had prolonged fever (fever for 7 days or longer before diagnosis). Eleven (73%) cases were cryptogenic in origin. Most of the microorganisms were obtained solely from cultures of pus. Klebsiella pneumoniae was the most common organism isolated (6/15, 40%). Beside administration of antibiotics, percutaneous catheter drainage (PCD) was performed in 11 patients (73%); only one underwent surgical intervention due to poor response to PCD management. All of our patients were surviving after at least one year follow-up. In conclusion, liver abscess should be suspected in the patients with prolonged fever of unknown origin and abdominal pain. PCD combined with adequate antibiotics were sufficient for therapy of liver abscess in most cases. K. pneumoniae was the most common isolated pathogen in southern Taiwan. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。