重症急性胰腺炎继发感染的临床特点  

Clinical Investigation of Severe Acute Pancreatitis Complicated with Infection

作　　者：文礼[1] 赵龙[1] 金涛[1] 张海燕[1] 黄蕾[1] 杨晓楠[1] 薛平[1] 夏庆[1] 刘续宝[2] 程征宇[1] 

机构地区：[1]四川大学华西医院中西医结合科,成都610041 [2]四川大学华西医院普外科,成都610041

出　　处：《中国中西医结合外科杂志》2010年第2期148-151,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家科技支撑计划项目(2006BAI04A15);四川省急性胰腺炎中西医结合防治中心建设项目(川中医药办发[2009]1号)

摘　　要：目的:探讨重症急性胰腺炎继发感染的临床特点。方法:回顾分析发病后72h内入院、病程中出现了感染并发症且资料完善的66例患者的临床资料,探讨其临床特点。结果:重症急性胰腺炎伴感染患者的总病死率为37.9%,66例共继发88个器官感染,共培养出76(49.7%)G-菌株、17(11.1%)G+菌株,60(39.2%)真菌株。胰腺感染占总感染病例的34.8%(23/66),伴有胰腺或胰周感染患者的病死率高于无胰腺感染患者(P<0.05)。真菌感染32例,其中单纯真菌感染4例,包括尿道2例,肺部和血液各1例,其余病例均伴有细菌感染。结论:重症急性胰腺炎继发胰腺或胰周感染是最为严重的感染并发症;真菌感染有增加的趋势,临床工作中要注意合理使用抗生素。Objective To investigate the clinical characteristics of severe acute pancreatitis（SAP） complicated with infection.Methods Clinical data of 66 infected SAP patients who directly admitted to the hospital within 72 h after the onset of symptoms were retrospectively analyzed.Results The total mortality of infected SAP patients was 37.9%.Eight-eight organs were infected by 76（49.7%） stains of Gram-negative bacteria,17（11.1%） Gram-positive bacteria and 60（39.2%） by fungus.Pancreatic infection accounted for 34.8% and the mortality of the patient with pancreatic infection was higher than that of those with extrapancreatic infection（P 〈0.05）.There were 32 patients infected by fungus.Conclusion Pancreatic and peripancreatic infections are the fatal infections.Fungal infections are increasing,attention should paid to the rational use of antibiotics in our clinical fight against from secondary infection of SAP.

关 键 词：重症急性胰腺炎 感染 多脏器功能衰竭 

分 类 号：R657.51[医药卫生—外科学] R631[医药卫生—临床医学]