胰腺癌患者根治性切除术后腹腔感染的病原菌分析研究

发布时间：2019-07-11 08:02

【摘要】：目的探讨胰腺癌根治性切除术后腹腔感染的病原菌分布与耐药性特点,为临床治疗提供依据。方法回顾性分析解放军总医院2009年1月-2013年12月318例胰腺癌行根治性切除手术患者的临床资料,分析其术后腹腔感染的病原学特点与耐药性;采用SPSS 13.0软件进行统计分析。结果术后共发生腹腔感染42例,感染率为13.2%;引流液中分离出病原菌76株,其中革兰阴性菌占57.9%,革兰阳性菌占35.5%,真菌占6.6%;铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌对亚胺培南较为敏感,耐药率分别为7.7%、0和8.3%,屎肠球菌、金黄色葡萄球菌对替考拉宁和万古霉素较为敏感,耐药率分别为9.1%、9.1%和10.0%、0;白色假丝酵母菌对氟康唑和伏立康唑均敏感。结论腹腔感染是胰腺癌根治性切除术后常见的并发症,减少术中污染和术后通畅引流是其预防的有效措施,根据引流液培养结果应用合理抗菌药物是其治疗的关键。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in abdominal infection after radical resection of pancreatic cancer, and to provide evidence for clinical treatment. Methods the clinical data of 318 patients with pancreatic cancer undergoing radical resection from January 2009 to December 2013 in PLA General Hospital were analyzed retrospectively, and the etiological characteristics and drug resistance of postoperative abdominal infection were analyzed by SPSS 13.0 software. Results 42 cases of abdominal infection occurred after operation, the infection rate was 13.2%, 76 strains of pathogenic bacteria were isolated from drainage solution, including Gram-negative bacteria (57.9%), Gram-positive bacteria (35.5%) and fungi (6.6%). Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae were sensitive to imipenem, the resistance rates were 7.7%, 0% and 8.3%, respectively. Enterococcus faecium and Staphylococcus aureus were sensitive to teicoplanin and vancomycin, and the resistance rates were 9.1%, 9.1% and 10.0%, respectively. Conclusion Peritoneal infection is a common complications after radical resection of pancreatic cancer. Reducing intraoperative pollution and unobstructed drainage after operation is an effective measure to prevent pancreatic cancer. According to the results of drainage culture, the application of reasonable antibiotics is the key to its treatment.
【作者单位】：临沂市沂水中心医院普外二科;解放军总医院肝胆外科;
【基金】：全军医学科研“十二五”基金资助项目(CWS11J096)
【分类号】：R446.5

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