低白细胞血症肠瘘病人细菌感染危险因素分析  

Risk factors for bacterial infection in leucopenia patients with gastrointestinal fistula

作　　者：周郑[1] 任建安[1] 刘海燕[2] 顾国胜[1] 黎介寿[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院解放军普通外科研究所,江苏南京210002 [2]安徽医科大学第一附属医院重症医学科,安徽合肥230022

出　　处：《中国实用外科杂志》2011年第2期157-158,共2页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(30872456)

摘　　要：目的分析导致低白细胞血症的肠瘘病人发生细菌感染的危险因素。方法对2007年1月至2008年6月南京大学医学院临床学院南京军区南京总医院诊治98例肠瘘病人的临床资料进行回顾性分析。98例病人分为研究组和对照组,研究组由25例发生细菌感染的低白细胞血症肠瘘病人组成,对照组由73例细菌感染阴性的低白细胞血症肠瘘病人组成。结果导致低白细胞血症肠瘘病人发生细菌感染的唯一独立危险因素是中心静脉置管,在研究组的置管率为40%,在对照组的置管率仅为5.48%。其他危险因素包括:肝功能不全、机械通气和导尿管留置。导致细菌感染阳性的低白细胞血症肠瘘病人发生死亡的危险因素为肾功能不全和导尿管留置。结论中心静脉置管是导致低白细胞血症肠瘘病人发生细菌感染的最主要危险因素。这一结论有助于临床医师采取更有效的针对性治疗措施以降低细菌感染的发生率,改善肠瘘病人的预后。Objective To find risk factors for bacterial infection in leucopenia patients with gastrointestinal fistula. Methods The clinical data of 98 leucopenia patients with gastrointestinal fistula admitted between January 2007 and June 2008 at the General Surgical Institute of Jinling Hospital of Nanjing Univeristy were analyzed retrospectively. Cases consisted of 25 patients with bacterial infection positive and controls consisted of 73 patients with bacterial infection negative. Results The only independent determinant was central vein catheter, with in cases, 40% of patients had central vein catheter, whereas only 5.48% of patients in controls had central vein catheter. Other risk factors included hepatic dysfunction, mechanical ventilation and urinary catheter. The factors most strongly associated with mortality in controls were renal insufficiency and urinary catheter. Conclusion Central vein catheter is by far the most important predisposing factor to bacterial infection in leucopenia patients with gastrointestinal fistula. The data will help clinicians to give gastrointestinal fistula patients more supportive management and prevention strategies to treat bacterial infections.

关 键 词：危险因素 细菌感染 低白细胞血症 肠瘘 

分 类 号：R6[医药卫生—外科学]