胰腺切除术后腹腔感染的菌谱分析及治疗体会  

Analysis of bacterial spectrum and management of intra-abdominal infection after pancreatic operation

作　　者：徐彬[1] 靳大勇[1] 宋永蔚[1] 牛耿明[1] 戎叶飞[1] 楼文晖[1] 

机构地区：[1]复旦大学附属中山医院普外科胰腺肿瘤专业组,上海200030

出　　处：《中国实用外科杂志》2007年第5期401-402,共2页Chinese Journal of Practical Surgery

摘　　要：目的了解胰腺切除术后腹腔感染的菌谱、药敏状况,探讨其有效治疗措施。方法在2005年11月至2006年7月间前瞻性收集42例胰腺切除术后病人腹腔内引流液进行细菌培养及药敏试验,记录病人术后相应的临床表现、辅助检查结果、治疗措施和腹腔引流管状况。结果腹腔内引流液普通细菌培养阳性者占40.5%,以G+菌为主,且往往呈现多药耐药。术后未发生腹腔感染者和发生腹腔感染者两组术后平均住院时间分别为16.1d和22.8d(P<0.01),腹腔引流管平均留置时间分别为16.8d和35.8d(P<0.01)。术后合并腹腔感染需抗生素治疗组和单纯通畅引流治疗组平均住院时间及腹腔引流管留置时间差异无统计学意义(P>0.05)。结论胰腺切除术后预防性应用抗生素的腹腔感染细菌主要为G+菌,发生腹腔感染的治疗以通畅引流为主。Objective To investigate bacterial spectrum, drug sensitivity and management of intra-abdominal infection occurred in the patients with prophylactic antibiotics after pancreatic operation. Methods Prospectively collected intraabdominal drain liquid for bacterial culture and drug sensitivity test, and the outcome and clinical data were recorded thoroughly. Results The incidence of the positive result of bacterial culture was 40. 5%. The bacterial spectrum was mainly gram positive bacterium which always displayed muhidrug resistance, Prolonged hospital stay （ 22.8 days versus 16.1 days, P 〈0.01 ）and longer drain time （35.8 days versus 16. 8 days, P 〈0.01 ） were observed in the positive intra-abdominal infection （IAI） group. No statistical significance was observed on hospital stay and drain time between the patients with sensitive antibiotic treatment and patients without. Conclusion On prophylactic antibiotics use, the bacterial spectrum found in IAI after pancreatic surgery was mainly G ^＋, Postoperative stay and drain time was prolonged in IAI patients group, Treatment for postoperative IAI is primarily persistent and unobstructed drainage

关 键 词：胰腺 腹腔内感染 细菌培养 药敏试验 

分 类 号：R6[医药卫生—外科学]