摘要
目的 回顾性分析2010年6月至2015年12月福建医科大学附属泉州第一医院消化内科收治的280例重症急性胰腺炎（SAP）患者的临床资料,找出合并腹腔感染相关的易感因素,并进行细菌培养及药物敏感性分析,以便能更好地进行诊治与预防.方法 收集280例SAP患者的临床资料,将腹腔感染患者与无腹腔感染患者的临床指标进行logistic回归分析,分析SAP合并腹腔感染的易感因素.收集SAP合并腹腔感染的腹水或坏死组织的标本,进行细菌培养及药物敏感性分析.结果 器官功能衰竭数、腹腔积液、血钙（Ca）、肠功能障碍是SAP合并腹腔感染的易感因素,主要致病菌仍为革兰氏阴性菌.排名前两位的革兰氏阴性菌为大肠埃希菌和铜绿假单胞菌,排名前两位的革兰氏阳性菌为肠球菌和金黄色葡萄球菌.两类常见的致病菌均对常用抗生素普遍不敏感.结论 临床上早期SAP合并腹腔感染的治疗需针对其易感因素、常见的致病菌谱及药物敏感性采取相应的治疗措施,以提高临床治疗的效果.
Objective The aim of the study was to find out the risk factors of the severe acute pancreatitis（SAP）complicated with intra-abdominal infections according to the retrospective analysis of the clinical data of 280 patients with SAP in Quanzhou First Hospital of Fujian Medical University,and to analyze the bacterial spectrum,drug sensitivity in patients with intra-abdominal infections for clinical diagnosis and treatment.Methods Collected the clinical data of 280 patients,the relationship between the factors which have significant difference in patients complicated with intra-abdominal infections and no intra-abdominal infections patients was explored according to the Logistic regression analysis,and analysized the predisposing factor of SAP complicated with the intra-abdominal infections.The ascite specimens and the necrotic tissues of SAP patients complicated with the intra-abdominal infections were harvested for bacterial culture and drug sensitivity analysis.Results The Multiple organ dysfunction syndrome,seroperitoneum,Ca and intestinal dysfunction were the risk factors of SAP with the intra-abdominal infections,the main pathogenic bacteria was gram-negative bacteria.The top two gram-negative bacteria were Escherichia coli,pseudomonas aeruginosa,and the top two gram-positive bacterium were enterococcus,staphylococcus aureus.They were generally not sensitive to common antibiotics.Conclusion The early therapy of SAP complicated with the intra-abdominal infections should be basd on the risk factors,bacterial spectrum,and drug sensitivity,in order to increase the clinical therapeutic effect.
出处
《中国临床实用医学》
2017年第4期26-30,共5页
China Clinical Practical Medicine
