急性重症胰腺炎患者腹腔感染的临床诊断及治疗

发布时间：2018-05-11 11:31

本文选题：急性重症胰腺炎 + 腹腔感染　；参考：《中华医院感染学杂志》2015年05期

【摘要】：目的探讨急性重症胰腺炎患者并发腹腔感染的临床诊断方法,统计常见病原菌及抗菌药物敏感性,为临床诊治急性重症胰腺炎提供参考。方法选取2009年4月-2013年10月急性重症胰腺炎并腹腔感染的患者79例,对其临床表现进行回顾性分析,并行病原菌培养和抗菌药物敏感性分析。结果 79例患者共检出病原菌84株,以革兰阴性菌最为首,检出65株占77.38%,以大肠埃希菌和肺炎克雷伯菌检出率最高,分别占39.29%和17.86%;革兰阳性菌检出16株占19.05%,其中葡萄球菌属占10.71%,真菌检出率最低,占3.57%;革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/舒巴坦最为敏感,敏感率分别为100.00%、89.23%和80.00%,而对氨苄西林敏感性较低,仅18.46%;革兰阳性菌对万古霉素、利奈唑胺表现出了高度的敏感,敏感率达100.00%,对青霉素敏感率最低,仅为31.25%。结论急性重症胰腺炎并发感染者多有典型的临床表现,在确诊之后应及时给予抗菌药物经验性治疗,并及时进行病原菌培养和药敏试验,待结果报告后及时调整用药。
[Abstract]:Objective to investigate the clinical diagnosis of abdominal infection in patients with severe acute pancreatitis and to calculate the sensitivity of common pathogens and antimicrobial agents, and to provide reference for clinical diagnosis and treatment of severe acute pancreatitis. Methods 79 patients with severe acute pancreatitis complicated with abdominal infection from April 2009 to October 2013 were selected and their clinical manifestations were retrospectively analyzed and the pathogen culture and antimicrobial susceptibility were analyzed. Results A total of 84 strains of pathogenic bacteria were detected in 79 patients, among which gram-negative bacteria were the first, 65 strains were found in 77.38 strains, and the detection rates of Escherichia coli and Klebsiella pneumoniae were the highest. There were 16 Gram-positive bacteria (19.05%), among which Staphylococcus was 10.71, fungi was the lowest (3.57%), Gram-negative bacteria were most sensitive to imipenem, cefoperazone / sulbactam, piperacillin / sulbactam, Gram-negative bacteria were most sensitive to imipenem, cefoperazone / sulbactam and piperacillin / sulbactam. The sensitivity rates of Gram-positive bacteria to vancomycin and linazolamine were 100.0023% and 80.003%, respectively, while the sensitivity to ampicillin was only 18.46.The sensitivity rate of gram-positive bacteria to vancomycin and linazolamine was 100.000.The sensitivity rate to penicillin was the lowest, only 31.25%. Conclusion most patients with severe acute pancreatitis complicated with infection have typical clinical manifestations. After diagnosis, antibiotics should be treated empirically, pathogen culture and drug sensitivity test should be carried out in time, and drug use should be adjusted immediately after the results are reported.
【作者单位】：南阳市中心医院肝脏普外科;
【基金】：河南省卫生厅基金资助项目(HW-2010B-034)
【分类号】：R576

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