感染相关性胆汁淤积症35例临床分析  

Clinical analysis of 35 cases of sepsis-associated cholestasis

作　　者：樊和斌[1] 陈安慎[1] 严福明[1] 马燕妮[2] 朱幼芙[3] 杨东亮[4] 

机构地区：[1]中国人民解放军第161医院感染科,湖北武汉430030 [2]中国人民解放军第161医院急诊科 [3]南方医科大学南方医院感染科 [4]武汉同济医院临床免疫研究室

出　　处：《胃肠病学和肝病学杂志》2010年第4期367-368,共2页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨感染相关性胆汁淤积症的临床特点,以提高对该病的认识。方法回顾性分析35例感染相关性胆汁淤积症感染发生的部位、感染菌谱、临床特点、肝功能改变及治疗转归。结果引起感染相关性胆汁淤积症感染灶分别来自胆道15例(42.9%)、泌尿道7例(20%)、腹腔4例(11.4%)、肠道5例(14.3%)及呼吸道4例(11.4%)。感染菌谱以革兰氏阴性菌多见,占77.8%。主要临床表现为感染中毒症、高黄疸及肝功能损害。经抗感染并给予护肝利胆治疗大多在1个月内治愈,死亡4例,占11.4%(均为肝硬化合并腹腔内感染)。结论感染可引起胆汁淤积,经积极治疗大多数病人预后良好,但少数可迁延不愈甚至死亡。Objective To analyze the clinical characteristics of sepsis-associated cholestasis.Methods Thirty-five cases of sepsis-associated cholestasis were retrospected and the focal infection,pathogenic bacteria,clinical characteristics,changes of liver function and prognosis were collected and analyzed.Results The sepsis-associated cholestasis could be induced by the bacterial infection of biliary tract（15 cases,42.9%）,urinary tract（7 cases,20%）,abdominal cavity（4 cases,11.4%）,gastrointestinal tract（5 cases,14.3%）,respiratory tract（4 cases,11.4%）.Gam-negative microorganisms accounted for 77.8%.The clinical manifestations were sepsis syndrome,high jaundice and liver function impairment.Most patients were recovered completely through 1 month by anti-infective and hepatic protection drug.Four cases were complicated with hepatic cirrhosis and all died finally（11.4%）.Conclusion The infection can induce cholestasis and most patients can recover from active treatment.

关 键 词：胆汁淤积 菌血症 临床分析 

分 类 号：R575.6[医药卫生—消化系统]