自 20 世纪 80 年代以来,随着新的引流技术和抗生素的出现,肝脓肿的死亡率一直在降低。在肝脓肿患者中,住院死亡率为 2.5% 至 19%。[1]Kaplan GG, Gregson DB, Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess. Clin Gastroenterol Hepatol. 2004;2:1032-1038.http://www.ncbi.nlm.nih.gov/pubmed/15551257?tool=bestpractice.com[2]Mohsen AH, Green ST, Read RC, et al. Liver abscess in adults: ten years experience in a UK centre. QJM. 2002;95:797-802.https://academic.oup.com/qjmed/article/95/12/797/1572029/Liver-abscess-in-adults-ten-years-experience-in-ahttp://www.ncbi.nlm.nih.gov/pubmed/12454322?tool=bestpractice.com[4]Meddings L, Myers RP, Hubbard J, et al. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105:117-124.http://www.ncbi.nlm.nih.gov/pubmed/19888200?tool=bestpractice.com[12]Jepsen P, Vilstrup H, Schønheyder HC, et al. A nationwide study of the incidence and 30-day mortality rate of pyogenic liver abscess in Denmark, 1977-2002. Aliment Pharmacol Ther. 2005;21:1185-1188.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2005.02487.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/15882238?tool=bestpractice.com[22]Alvarez Pérez JA, González JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess. Am J Surg. 2001;181:177-186.http://www.ncbi.nlm.nih.gov/pubmed/11425062?tool=bestpractice.com[50]Ruiz-Hernández JJ, León-Mazorra M, Conde-Martel A, et al. Pyogenic liver abscesses: mortality-related factors. Eur J Gastroenterol Hepatol. 2007;19:853-858.http://www.ncbi.nlm.nih.gov/pubmed/17873608?tool=bestpractice.com在美国的一项基于大量人群的研究中,化脓性肝脓肿的住院死亡率是 5.6%,并且从 1994 年至 2005 年一直保持稳定。[4]Meddings L, Myers RP, Hubbard J, et al. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105:117-124.http://www.ncbi.nlm.nih.gov/pubmed/19888200?tool=bestpractice.com并发症发生率增加与年龄增长、休克、入住 ICU、菌血症、多种共存疾病、肝硬化、慢性肾衰竭、癌症、黄疸、真菌感染、胆源性脓肿、急性呼吸衰竭、抗生素治疗不当以及疾病的严重程度重相关。[4]Meddings L, Myers RP, Hubbard J, et al. A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends. Am J Gastroenterol. 2010;105:117-124.http://www.ncbi.nlm.nih.gov/pubmed/19888200?tool=bestpractice.com[50]Ruiz-Hernández JJ, León-Mazorra M, Conde-Martel A, et al. Pyogenic liver abscesses: mortality-related factors. Eur J Gastroenterol Hepatol. 2007;19:853-858.http://www.ncbi.nlm.nih.gov/pubmed/17873608?tool=bestpractice.com[51]Chen SC, Huang CC, Tsai SJ, et al. Severity of disease as main predictor for mortality in patients with pyogenic liver abscess. Am J Surg. 2009;198:164-172.http://www.ncbi.nlm.nih.gov/pubmed/19268905?tool=bestpractice.com[52]Chen W, Chen CH, Chiu KL, et al. Clinical outcome and prognostic factors of patients with pyogenic liver abscess requiring intensive care. Crit Care Med. 2008;36:1184-1188.http://www.ncbi.nlm.nih.gov/pubmed/18379245?tool=bestpractice.com与没有胆道疾病的患者相比,肝脓肿复发在有基础胆道疾病的患者中更常见。[47]Cheng HC, Chang WL, Chen WY, et al. Long-term outcome of pyogenic liver abscess: factors related with abscess recurrence. J Clin Gastroenterol. 2008;42:1110-1115.http://www.ncbi.nlm.nih.gov/pubmed/18458641?tool=bestpractice.com