急性盆腔感染患者病原菌分布及临床分析

发布时间：2018-03-27 14:47

本文选题：急性盆腔感染　切入点：病原菌　出处：《四川大学学报(医学版)》2017年04期

【摘要】：目的探讨急性盆腔感染患者的病原菌分布,探讨适当的干预对策。方法随机选取2010年1月至2015年12月本院收治的118例急性盆腔感染患者为研究对象,回顾性分析临床资料,血液标本或留取的盆腔标本的细菌培养结果,以及检测病原菌分布及药敏情况,分析该病的临床特点及抗生素疗效。结果共分离出病原菌58株,其中革兰阴性菌占55.17%(32株),革兰阳性菌占27.59%(16株),真菌占10.34%(6株)。有62例患者接受手术治疗或者有创引流,手术治疗或有创引流的患者与保守治疗的患者相比较,降钙素原、CA125、盆腔包块最大径、凝血功能异常发生率、升级抗生素的比例、感染性休克发生率、ICU入住率及住院时间等差异均具有统计学意义(P0.05)。抗生素对于盆腔严重感染有效性依次为碳青霉烯类、万古霉素、四代头孢合用奥硝唑、合成青霉素类+β内酰胺酶抑制药、莫西沙星、三代头孢合用奥硝唑、二代头孢合用奥硝唑。结论引起女性严重盆腔感染最常见的细菌为大肠埃希菌,对氨苄西林及头孢曲松等药耐药率较高,最有效抗生素为碳青霉烯类。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria in patients with acute pelvic infection, to explore the appropriate intervention strategies. Methods 118 cases of acute pelvic from January 2010 to December 2015 in our hospital were randomly selected from infected patients as the research object, a retrospective analysis of clinical data, blood specimens or specimens from the pelvic specimens of bacterial culture results, and detect the distribution of pathogenic bacteria and drug sensitivity analysis, clinical characteristics and antibiotic efficacy in the treatment of this disease. Results a total of 58 strains of bacteria were isolated, gram negative bacteria accounted for 55.17% (32 strains), gram positive bacteria accounted for 27.59% (16 strains), fungi accounted for 10.34% (6 strains). 62 patients underwent surgery or invasive drainage surgical treatment, or invasive drainage in patients with conservative treatment were compared, procalcitonin, CA125, maximum diameter of pelvic mass, the incidence of abnormal coagulation function, upgrade the proportion of antibiotics, the incidence of septic shock, ICU occupancy rate and hospitalization The time difference was statistically significant (P0.05). The effectiveness of antibiotics for severe pelvic infection were carbopenems, vancomycin, four generation cephalosporin combined ornidazole, synthetic penicillin + beta lactamase inhibitor, moxifloxacin, three generation cephalosporins combined with Ornidazole, two generation cephalosporins combined with Ornidazole. Conclusion the cause of women with severe pelvic infection with Escherichia coli was the most common bacteria to ampicillin and ceftriaxone, high drug resistance rate, the most effective antibiotics for carbapenems.

【作者单位】：重庆医科大学附属第一医院妇科;
【分类号】：R711.33

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