| 徐圣,石宝琪,朝鲁孟,谭永胜,张学军.经皮穿刺置管引流术治疗不同糖化血红蛋白水平糖尿病肝脓肿患者的预后分析[J].中国介入影像与治疗学,2019,16(9):550-554 |
| 经皮穿刺置管引流术治疗不同糖化血红蛋白水平糖尿病肝脓肿患者的预后分析 |
| Prognostic analysis for diabetic pyogenic liver abscess patients in different levels of haemoglobin treated with percutaneous catheter drainage |
| 投稿时间：2019-05-20 修订日期：2019-07-26 |
| DOI：10.13929/j.1672-8475.201905031 |
| 中文关键词: 糖尿病 肝脓肿 经皮穿刺置管引流术 糖化血红蛋白 休克,脓毒性 |
| 英文关键词:diabetes mellitus liver abscess percutaneous catheter drainage glycosylated hemoglobin shock, septic |
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| 中文摘要: |
| 目的 比较不同糖化血红蛋白（HbA1c）水平糖尿病（DM）伴肝脓肿（PLA）患者经皮穿刺置管引流术（PCD）治疗的预后，探讨影响术后总恢复时间（ORT）的因素。方法 回顾性分析接受PCD治疗的33例DM伴PLA患者，根据HbA1c水平分为A组（HbA1c<7%，n=11）、B组（7%≤HbA1c<9%，n=9）及C组（HbA1c≥9%，n=13），比较3组治疗有效率、ORT及复发率。采用Log-rank检验及Cox多因素回归分析探讨影响ORT的因素。结果 PCD治疗有效率为100%（33/33），平均ORT为（24.30±11.60）天，平均拔管时间（27.76±12.03）天；平均随访时间（11.02±6.51）个月。3组PLA复发率差异无统计学意义（P＝0.140），ORT比较差异有统计学意义（P=0.002）。单因素及多因素分析显示，感染性休克[风险比（HR）=0.320，95% CI（0.131，0.777），P=0.012]和HbA1c≥7%[HR=0.249，95% CI（0.104，0.594），P=0.002]是影响ORT的因素。结论 对于DM伴PLA患者，HbA1c水平越高，经PCD治疗后ORT越长。感染性休克及HbA1c是影响ORT的因素。 |
| 英文摘要: |
| Objective To compare the prognosis of diabetic pyogenic liver abscess (PLA) patients with different levels of haemoglobin (HbA1c) treated with percutaneous catheter drainage (PCD), and to identify the predictors for overall recovery time (ORT) after PCD. Methods Thirty-three diabetic PLA patients underwent PCD were retrospectively reviewed and divided into three groups based on HbA1c level, including group A (HbA1c<7%, n=11), group B (7% ≤ HbA1c<9%, n=9) and group C (HbA1c ≥ 9%, n=13). The clinical success rate of PCD, ORT and recurrence rate of PLA were compared. Predictors of ORT were analyzed via univariate analysis (Log-rank test) and Cox multi-factor regression analysis. Results The clinical success rate of PCD for treating PLA was 100% (33/33), with the mean ORT of (24.30±11.60) days. The mean catheter removal time and follow-up time was (27.76±12.03) days and (11.02±6.51) months, respectively. There was no significant difference of recurrence rate of PLA among three groups (P=0.140). However, significant difference of ORT (P=0.002) was found among three groups. Univariate analysis and multivariate analysis indicated that septic shock (hazard ratio[HR]=0.320, 95%CI[0.131, 0.777], P=0.012) and HbA1c ≥ 7% (HR=0.249, 95%CI[0.104, 0.594], P=0.002) were predictors for ORT. Conclusion For diabetic PLA patients, the higher level of HbA1c, the longer the ORT. Septic shock and HbA1c are predictors for ORT. |
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