糖尿病患者急性阑尾炎术后切口感染的危险因素分析

发布时间：2018-05-01 11:08

本文选题：糖尿病 + 急性阑尾炎　；参考：《中华医院感染学杂志》2017年12期

【摘要】：目的调查糖尿病并发急性阑尾炎术后切口感染的病原菌及其耐药性特点,并对危险因素进行分析。方法回顾性分析2014年3月-2016年3月期间医院收治的159例糖尿病并发急性阑尾炎患者的细菌培养、药敏试验结果和临床资料情况。结果 159例糖尿病并发急性阑尾炎患者发生切口感染38例,感染率为23.90%;共分离得到46株病原菌,其中革兰阴性菌29株(63.04%),革兰阳性菌17株(36.96%);大肠埃希菌、铜绿假单胞菌及金黄色葡萄球菌均对氨苄西林、哌拉西林的耐药率较高(均70.00%);χ~2检验分析,糖尿病并发急性阑尾炎术后切口感染与年龄、阑尾炎类型、住院时间、术前血糖、术后血糖和手术时间呈显著相关性(P0.05);Logistic回归模型分析显示,年龄、阑尾炎类型、术后血糖和手术时间是糖尿病并发急性阑尾炎术后切口感染的独立危险因素(P0.05)。结论糖尿病并发急性阑尾炎术后切口感染以革兰阴性菌为主,耐药现象较为严重,危险因素较多,临床应根据药敏试验结果和相关因素采取针对性预防控制措施。
[Abstract]:Objective to investigate the pathogenic bacteria and drug resistance of incision infection in diabetes mellitus complicated with acute appendicitis, and to analyze the risk factors. Methods the bacterial culture, drug sensitivity test and clinical data of 159 patients with diabetes mellitus complicated with acute appendicitis from March 2014 to March 2016 were retrospectively analyzed. Results 38 cases of incision infection occurred in 159 cases of diabetes mellitus complicated with acute appendicitis, the infection rate was 23.900.A total of 46 pathogenic bacteria were isolated, of which 29 strains were Gram-negative bacteria (29 strains), 17 strains were Gram-positive bacteria (36.96C), the other were Escherichia coli. Both Pseudomonas aeruginosa and Staphylococcus aureus showed higher resistance to ampicillin and piperacillin (all 70.002%). 蠂 2 test showed that incision infection and age, type of appendicitis, length of stay, preoperative blood sugar, postoperative wound infection and age of diabetes mellitus complicated with acute appendicitis, Logistic regression analysis showed that age, type of appendicitis, postoperative blood glucose and operative time were the independent risk factors of postoperative incision infection in diabetic patients with acute appendicitis. Conclusion Gram-negative bacteria is the main wound infection of diabetes mellitus complicated with acute appendicitis after operation. The drug resistance is more serious and the risk factors are many. The clinical prevention and control measures should be taken according to the results of drug sensitivity test and related factors.
【作者单位】：河南省焦作市人民医院普外一科;
【分类号】：R587.1;R656.8

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