老年急性胆道感染非手术治疗的临床分析

发布时间：2018-05-01 18:47

本文选题：老年 + 急性胆道感染　；参考：《中华医院感染学杂志》2015年03期

【摘要】：目的探讨老年急性胆道感染的非手术治疗方法,以提高老年急性胆道感染的治疗水平。方法选取2011年4月-2013年8月老年急性胆道感染患者224例,随机分为对照组和观察组,每组各112例,取两组患者胆汁标本行细菌培养和药物敏感试验,对照组患者单纯敏感抗菌药物治疗,观察组患者在对照组基础上给予消炎利胆片口服,对两组患者治疗效果、住院时间进行评价和统计。结果 224例患者共检出病原菌231株,其中革兰阴性菌191株占82.68%,以大肠埃希菌最为常见,革兰阳性球菌38株占16.45%,真菌2株占0.87%;革兰阴性菌对哌拉西林、环丙沙星、左氧氟沙星以及磺胺甲VA唑/甲氧苄啶敏感性较低,均60.00%,而对阿米卡星敏感性较高,为95.81%,此外对美罗培南和头孢他啶的敏感率80.00%;革兰阳性菌对红霉素敏感性较低为52.63%,而对替考拉定、万古霉素、氯霉素以及氨苄西林的敏感性较高,均90.00%;观察组患者治疗效果明显优于对照组,且住院时间明显短于对照组,两组比较差异有统计学意义(P0.05)。结论对于老年急性胆道感染患者采取非手术治疗时应根据细菌培养结果选择敏感抗菌药物,在敏感抗菌药物治疗的基础上给予中成药消炎利胆片口服,有利于提高患者的治疗效果,并缩短疗程。
[Abstract]:Objective to explore the non-operative treatment of acute biliary tract infection in the elderly and to improve the treatment level of acute biliary tract infection in the elderly. Methods 224 elderly patients with acute biliary tract infection from April 2011 to August 2013 were randomly divided into control group and observation group with 112 cases in each group. Bacterial culture and drug sensitivity test were performed in two groups of bile samples. The patients in the control group were treated with simple sensitive antimicrobial agents and the patients in the observation group were treated with Xiaoyanlidan tablet on the basis of the control group. The therapeutic effect and hospitalization time of the two groups were evaluated and counted. Results 231 strains of pathogenic bacteria were detected in 224 patients, of which 191 strains were Gram-negative bacteria (82.68%), among which Escherichia coli was the most common, Gram-positive cocci (38 strains) accounted for 16.45%, fungi (2 strains) were 0.87 strains, Gram-negative bacteria were piperacillin, ciprofloxacin (ciprofloxacin), Levofloxacin and sulfamethazol / trimethoprim were less sensitive than those of sulfamethoxazole / trimethoprim, but sensitive to amikacin was higher than that of levofloxacin and sulfamethoxazole / trimethoprim. The sensitivity to meropenem and ceftazidime was 80.00. the sensitivity of gram-positive bacteria to erythromycin was 52.63, and to teicoplanin, vancomycin, chloramphenicol and ampicillin was higher. The therapeutic effect of the observation group was obviously better than that of the control group, and the hospitalization time was significantly shorter than that of the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion for the elderly patients with acute biliary tract infection, sensitive antimicrobial agents should be selected according to the results of bacterial culture, and the traditional Chinese patent medicine Xiaoyanlidan tablet should be given orally on the basis of the treatment of sensitive antimicrobial agents. It is beneficial to improve the therapeutic effect of patients and shorten the course of treatment.
【作者单位】：中山大学孙逸仙纪念医院肝胆外科;
【基金】：广州市卫生局基金资助项目(GW-2010B028)
【分类号】：R575.7

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