肛瘘感染患者血清与引流液炎症介质的变化观察

发布时间：2018-06-19 05:22

本文选题：肛瘘 + 感染　；参考：《中华医院感染学杂志》2017年03期

【摘要】：目的探讨肛瘘感染患者血清及引流液炎症介质的变化,以便为肛瘘的临床诊治提供借鉴和参考依据。方法选取2014年1月-2015年9月医院临床收治45例肛瘘术后感染患者为感染组,另选45例肛瘘术后未发生感染患者为非感染组,对两组患者的红细胞计数、血红蛋白含量、红细胞平均体积、平均血红蛋白量、血红蛋白平均浓度、红细胞分布宽度等血常规指标和IL-1β、IL-6、TNF-α、PGE2、SP、BK等炎症介质指标进行观察和比较。结果感染组患者血红蛋白含量、红细胞平均体积和平均血红蛋白量分别为(80.23±4.32)g/L、(57.93±5.91)fl、(17.23±2.71)pg,显著低于非感染组(123.28±3.12)g/L、(79.34±5.43)fl、(26.93±1.02)pg;感染组患者IL-1β、IL-6、TNF-α、PGE2、SP和BK分别为(2.71±0.33)pg/ml、(9.13±1.28)pg/ml、(1.88±0.23)ng/ml、(176.34±18.34)pg/ml、(6.54±1.34)μg/ml和(7.13±1.02)μg/L均明显的高于非感染组(1.61±0.23)pg/ml、(3.52±0.41)pg/ml、(0.77±0.12)ng/ml、(103.21±11.92)pg/ml、(1.56±0.21)μg/ml、(2.21±0.35)μg/L,且差异有统计学意义(P0.05);45例肛瘘术后感染患者共检出病原菌88株,其中革兰阴性菌66株占75.00%,革兰阳性菌18株占20.45%,真菌4株占4.55;革兰阴性菌对哌拉西林的敏感度高,对头孢曲松和头孢他啶的耐药性高,革兰阳性菌对克林霉素的敏感度高,对万古霉素和四环素的耐药性高。结论肛瘘感染患者血常规会呈现一定程度的改变趋势,同时感染患者引流液炎症介质水平会显著升高,针对上述指标的检测有利于临床感染的预防和诊治。
[Abstract]:Objective to explore the changes in the inflammatory mediators of serum and drainage fluid in patients with anal fistula infection in order to provide reference and reference for the clinical diagnosis and treatment of anal fistula. Methods 45 cases of infected patients after anal fistula operation in January 2014 -2015 years in September were selected as infection group, and 45 cases of uninfected patients after anal fistula operation were selected as non infected group, and two groups of patients were selected. Red blood cell count, hemoglobin content, mean corpuscular volume, mean hemoglobin volume, average hemoglobin concentration, red blood cell distribution width and other blood routine indexes, IL-1 beta, IL-6, TNF- a, PGE2, SP, BK and other inflammatory mediators were observed and compared. Results the hemoglobin content, the average volume of red blood cell and the average blood red blood in the infected group. Protein content was (80.23 + 4.32) g/L, (57.93 + 5.91) FL, (17.23 + 2.71) PG, significantly lower than non infection group (123.28 + 3.12) g/L, (79.34 + 5.43) FL, (26.93 + 1.02) PG, IL-1 beta, IL-6, TNF- alpha, PGE2, SP and BK, respectively, respectively. 1.02) mu g/L was significantly higher than that of non infected group (1.61 + 0.23) pg/ml, (3.52 + 0.41) pg/ml, (0.77 + 0.12) ng/ml, (103.21 + 11.92) pg/ml, (1.56 + 0.21) mu g/ml, (2.21 + 0.35) mu g/L, and the difference was statistically significant (P0.05). 20.45%, 4 fungi accounted for 4.55, Gram-negative bacteria were sensitive to piperacillin, high resistance to ceftriaxone and ceftazidime, high sensitivity to clindamycin, high resistance to clindamycin and high resistance to vancomycin and tetracycline. The level of fluid inflammatory mediators will increase significantly, and the detection of these indicators is conducive to the prevention and treatment of clinical infection.
【作者单位】：贵州省中医医院肛肠科;
【基金】：贵州省科技厅联合基金资助项目(黔科合中药字[2012]LkZ7047)
【分类号】：R657.16

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