摘要
目的分析梗阻性黄疸患者实施经皮经肝胆道引流术(PTCD)后胆道感染的临床相关因素,以降低术后胆道感染的发生。方法选取2012年11月-2014年11月于医院接受经皮经肝胆道引流手术治疗的梗阻性黄疸患者136例为观察对象,采用回顾性研究方式分析术后感染率、感染病原菌构成及感染的相关因素;采用SPSS18.0软件对试验数据进行统计分析。结果 136例患者中有35例术后发生胆道感染,感染率为25.74%;采集35例胆道感染患者的胆汁进行病原菌培养,共分离出病原菌58株,其中革兰阴性菌46株占79.31%,以大肠埃希菌、肺炎克雷伯菌及弗氏柠檬酸杆菌为主;PTCD术后胆道感染的发生与年龄、梗阻程度、术前黄疸时间、术前碱性磷酸酶浓度、术前总胆红素浓度、术前KPS值以及每日引流量密切相关(P<0.05),其中患者年龄、梗阻程度、术前黄疸时间、术前碱性磷酸酶浓度、每日引流量是独立影响因素。结论梗阻性黄疸患者PTCD术后胆道感染的影响因素较多,术前应积极调整身体状况,尽早采取PTCD手术,术后密切关注引流量,能为降低胆道感染的发生创造有利条件。
OBJECTIVE To investigate the related clinical factors for postoperative biliary tract infections in obstructive jaundice patients undergoing percutaneous transhepatic cholarryit drainage（PTCD）so as to reduce the incidence of postoperative biliary tract infections.METHODS A total of 136 patients with obstructive jaundice who were treated with PTCD from Nov 2012 to Nov 2014 were recruited as the study objects,then a retrospective survey was conducted for the incidence of postoperative infections,distribution of pathogens causing the infections,and the related factors for the infections,and the statistical analysis of experimental data was performed with the use of SPSS18.0software.RESULTS Of the 136 patients,35had postoperative biliary tract infections,with the infection rate 25.74%.Totally 58 strains of pathogens were isolated from bile specimens that were obtained from the 35 patients with biliary tract infections,including 46（79.31%）strains of gram-negative bacteria;the Escherichia coli,Klebsiella pneumoniae,and Citrobacter freundii were dominant among the gram-negative bacteria.The incidence of postoperative biliary tract infections in the patients undergoing PTCD was closely associated with the age,degree of obstruction,time of preoperative jaundice,concentration of preoperative alkaline phosphatase,concentration of preoperative total bilirubin,preoperative KPS value,and daily drainage volume（P〈0.05）;the independent influencing factors included the age,degree of obstruction,time of preoperative jaundice,concentration of preoperative alkaline phosphatase,and daily drainage volume.CONCLUSIONThere are a variety of influencing factors for the postoperative biliary tract infections in the obstructive jaundice patients undergoing PTCD.It is an effective way to actively adjust the physical condition before the surgery,perform the PTCD as early as possible,and pay close attention to the drainage volume after the surgery so as to reduce the incidence of the biliary tract infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第10期2296-2298,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫生计生委医药卫生科技计划基金资助项目(2013KYA079)
关键词
梗阻性黄疸患者
经皮经肝胆道引流术
胆道感染
影响因素
Obstructive jaundice patient
Percutaneous transhepatic cholarryit drainage
Biliary tract infection
Influencing factor
