胆总管结石患者胆汁病原菌培养阳性率及其相关因素分析

发布时间：2018-06-30 18:32

  本文选题：胆总管结石 + ERCP　； 参考：《广西医科大学》2014年硕士论文

【摘要】：目的：了解胆总管结石患者胆汁的菌群分布情况,探讨影响胆汁细菌培养阳性率的相关因素。 方法：回顾性分析本院2007年1月至2014年2月期间111例胆总管结石患者经内镜逆行胰胆管造影术(ERCP)获取胆汁的病原菌培养结果,并分析影响胆汁细菌培养阳性率的相关因素。 结果：111例胆总管结石患者胆汁病原菌培养阳性84例,阳性率为75.7%,共培养出85株病原菌,其中革兰阴性菌72株(占84.7%),革兰阳性菌12株(占14.1%),真菌1株(占1.’2%)。病原菌主要为埃希菌属(占62.4%),克雷伯菌属(占14.1%)。胆总管结石伴胆管炎患者胆汁病原菌培养阳性率81.18%,明显高于单纯胆总管结石的61.8%(P0.05)；多发结石患者胆汁病原菌培养阳性率为86.8%,明显高于单发结石组的65.5%(P0.05)；胆总管直径≥1.2cm患者胆汁病原菌培养阳性率为84.0%,明显高于1.2cm组的58.3%(P0.05)。胆汁培养病原菌阳性率在性别、年龄、术前是否使用抗生素、结石是否为泥沙样、既往是否有胆道手术史、既往是否有ERCP史、是否合并十二指肠乳头旁憩室均未见显著统计学差异(P0.05)。多因.素Logistic回归分析示胆总管结石伴胆管炎(P=0.026,OR=3.056)、多发结石(《=0.033,OR=3.006)、胆总管直径≥1.2cm (P=0.010,OR=3.589)均是胆汁病原菌培养阳性的危险因素。 结论：胆总管结石患者胆汁病原菌以埃希菌属、克雷伯菌属为主。伴胆管炎、多发结石、胆总管直径≥1.2cm是胆汁病原菌培养阳性的高危因素。ERCP术前是否使用抗生素与胆汁病原菌培养阳性率无关。
[Abstract]:Objective: to investigate the distribution of bacteria in bile of patients with choledocholithiasis and to explore the factors influencing the positive rate of bile culture. Methods: the results of bacterial culture in 111 patients with choledocholithiasis obtained by endoscopic retrograde cholangiopancreatography (ERCP) from January 2007 to February 2014 were retrospectively analyzed. Results 84 of 111 cases of choledocholithiasis were positive, the positive rate was 75.7%. A total of 85 strains of pathogenic bacteria were cultured, of which 72 were Gram-negative bacteria (84.7%), 12 Gram-positive bacteria (14.1%) and 1 fungus (1.42%). The main pathogens were Escherichia coli (62.4%) and Klebsiella (14.1%). The positive rate of bile pathogenic bacteria culture in patients with choledocholithiasis was 81.18, which was significantly higher than that in simple choledocholithiasis (61.8%) (P0.05), the positive rate of bile pathogenic bacteria culture in patients with multiple stones was 86.8%, which was significantly higher than that in single calculi group (65.5%) (P0.05). The positive rate of bile pathogen culture in patients with common bile duct diameter 鈮，

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