16例非伤寒沙门菌感染性主动脉瘤患者的临床分析

发布时间：2018-12-15 07:08

【摘要】：目的探索非伤寒沙门菌感染性主动脉瘤患者的临床特征,治疗及转归。方法收集医院2007年1月-2016年12月非伤寒沙门菌感染性主动脉瘤患者的基本特征、临床表现、疾病诊治以及临床结局等信息。结果 16例非伤寒沙门菌感染性主动脉瘤患者中,男15例,女1例,平均年龄(64.5±16.26)岁,多合并有高血压、糖尿病等基础疾病;主要症状为发热或局部疼痛;影像学提示多为假性动脉瘤,位置多在肾动脉以下;病原体以都柏林沙门菌和猪霍乱沙门菌为主,对氨苄西林及氨苄西林/舒巴坦耐药;入院3日内手术8例,抗感染后限期手术6例,治疗中出现动脉瘤破裂征象急诊手术1例,病情平稳、发病后多年手术1例;均予腔内修复术,即刻成功率100.00%;规则随访,9例疗效满意;3例死亡;3例局部脓肿形成,其中2例抗感染同时经外科治疗后好转,1例患者拒绝外科治疗、单纯内科治疗好转后失访;1例患者术后出院后失访。结论非伤寒沙门菌感染性主动脉瘤常发病于有基础疾病的老年人,症状相对不特异,病情凶险,微生物学检查和必要的血管影像学检查意义重大,恰当的抗感染治疗加上适时手术是治疗该病的基本原则。
[Abstract]:Objective to explore the clinical features, treatment and outcome of non-typhoid salmonella infection aortic aneurysm. Methods from January 2007 to December 2016, the basic characteristics, clinical manifestations, diagnosis and treatment of non-typhoid salmonella infection aortic aneurysm were collected. Results among the 16 patients with non-typhoid Salmonella infection aortic aneurysm, 15 were male and 1 female, with an average age of (64.5 卤16.26) years. Imaging findings showed that most of them were pseudoaneurysms, most of them were located below the renal artery, the pathogens were mainly Salmonella Dublin and Salmonella cholerae, and were resistant to ampicillin and ampicillin / sulbactam. 8 cases were operated within 3 days after admission, 6 cases were operated after anti-infective period, 1 case appeared ruptured aneurysm in the treatment, the condition was stable, 1 case was operated for many years after onset, all cases were treated with endovascular repair, the immediate success rate was 100.00000%. Regular follow-up showed satisfactory curative effect in 9 cases, death in 3 cases, local abscess in 3 cases, in which 2 cases were improved after surgical treatment, 1 case refused surgical treatment, and 1 case lost visit after simple medical treatment. One patient lost his visit after discharge. Conclusion Non-typhoid salmonella infection aortic aneurysms often occur in the elderly with underlying diseases, the symptoms are relatively non-specific, the condition is dangerous, the microbiological examination and the necessary vascular imaging examination are of great significance. Proper anti-infective therapy and timely surgery are the basic principles for the treatment of the disease.
【作者单位】：上海复旦大学附属中山医院感染病科;
【基金】：复旦大学附属中山医院基金资助项目(2016ZSG-209) 上海市第四轮公共卫生三年行动计划重点学科基金资助项目(15GWZK0101)
【分类号】：R543.16

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