重症急性胰腺炎并发肺部感染的临床分析  

Clinical study of pulmonary infection in severe acute pancreatitis

作　　者：高金波[1] 熊炯昕[1] 吕平[1] 王春友[1] 

机构地区：[1]华中科技大学协和医院普外科,武汉430022

出　　处：《消化外科》2005年第6期399-401,共3页Journal of Digestive Surgery

摘　　要：目的分析重症急性胰腺炎并发肺部感染的临床特点及危险因素,并探讨其防治措施。方法回顾性分析190例重症急性胰腺炎患者的临床资料,研究肺部感染的发生率、感染菌的种类,比较感染和非感染组死亡率以及采用Logistic回归分析方法分析肺部感染的危险因素。结果67例重症急性胰腺炎并发肺部感染,发生率为35.3%,感染者死亡率为28.4%,明显高于非感染组(P<0.05);感染菌以革兰阴性菌为主,占73.6%,以铜绿假单胞菌、肺炎克雷伯菌和鲍曼不动杆菌为多见;21例存在两种或两种以上病原菌混合感染;APACHEⅡ评分≥15、呼吸机治疗、气管切开、年龄≥60岁和手术治疗是肺部感染的高危因素。结论重症急性胰腺炎患者并发肺部感染的发病率和死亡率较高,应针对其感染特点及危险因素,及时采取相应防治措施,改善其预后。Objective To analyze the clinical characteristic and risk factors of puImonary infection in patients with severe acute pancreatitis, and investigate prevention and treatment strategy. Methods The clinical data of 190 cases with severe acute pancreatitis were analyzed, retrospectively. The pulmonary infection rate and pathogens species were studied. Logistic regression analyses was used for anlalysing the risk factors. Results Pulmonary infection was found in 67 cases, and the infection rate was 35.3%. The mortality of those infected patients was 28.4%, which was higher than that of the uninfected （ P〈0.05）. Gram-negative bacilli accounted for 73.6% of the pathogens, and the main pathogens were Pseudomonas aeruginosa, Klehsiella pneumoniae and Acinetohacter haumannii. The co-infectin with two species of bacteria or above was found in 21 cases. APACHE Ⅱ score 15, mechanical ventilation treatment, tracheotomy, age over 60 and operation treatment were the risk factors of pulmonary infection. Conclusions Pulmonary infection in severe acute pancreatitis patients with pulmonary infection had high morbidity and mortality. According to the character and risk factors of pulmonary infection, we should take measures to reduce the rate of infection.

关 键 词：重症急性胰腺炎 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统] R576[医药卫生—内科学]