中文摘要：

目的探讨隐源性细菌性肝脓肿的临床特点，为临床决策提供相关依据。方法回顾性分析2013年1月至2016年6月间浙江大学医学院附属第二医院肝胆胰外科连续收治的86例细菌性肝脓肿病人的临床资料。根据病因分为隐源性组（51例）和非隐源性组（35例）。比较两组临床表现、实验室及病原学检查结果、治疗及预后情况。结果隐源性组年龄、伴发胆管结石和恶性肿瘤比例低于非隐源性组，而男性病人和糖尿病病人比例高于非隐源性组（P〈0．05）；隐源性组出现血小板降低和总胆红素升高的比例低于非隐源性组（P〈0．05）；最常见病原茵为肺炎克雷伯茵，但隐源性组肺炎克雷伯菌的检出率明显高于非隐源性组（P〈0．05），而大肠埃希菌的检出率低于非隐源性组（P〈O．05）；两组治疗均以抗生素联合穿刺引流为主，但隐源性组住院时间较短，预后不良事件的发生率较低（P〈0．05）。结论隐源性细菌性肝脓肿好发于中老年男性糖尿病病人，主要病原菌为肺炎克雷伯茵，以控血糖、抗感染、积极穿刺引流为治疗原则，预后较好。

英文摘要：

Objective To explore the clinical characteristics of cryptogenic pyogenic fiver abscess （PLAC） and provide evidence for clinical decisions. Methods The clinical data of 86 patients with PLA admitted in Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to June 2016 were analyzed retrospectively. According to etiology, the patients were classified as cryptogenie group （n=51） and non-eryptogenic group （n=35）. Clinical manifestation, laboratory and pathogenic examination, treatment and prognosis were compared. Results Compared with non-cryptogenie group, the mean age and rate of biliary calculi and malignance were lower in cryptogenic group, while the rate of male and diabetes mellitus were higher （P〈0.05）. The rates of decreased PLT and elevated TBil in cryptogenic group were lower than those of non-cryptogenic group （P〈0.05）. Although klebsiella pneumoniae was the main pathogen in both groups, its rate in cryptogenic group was higher than that in non-cryptogenic group, while the rate of E. coli was lower in cryptogenic group （P〈0.05）. The cryptogenie group had better prognosis, which presented shorter hospital stay and less adverse events （P〈 0.05）. Conclusion PLAC tends to appear mostly in middle-aged and old men with diabetes mellitus. Klebsiella pneumoniae is the major pathogen. Controlling serum glucose, anti-infection and percutaneous drainage are effective treatment methods to Rain better prognosis.