不同程度急性胆管炎患者的胆汁细菌培养  

Types of bacteria in patients with different severity of acute cholangitis

作　　者：陈海川[1] 俞海波[1] 肖竣[1] 金肖丹[1] 陈雷[1] 

机构地区：[1]温州市第二人民医院温州医学院临床定理学院肝胆外科,325000

出　　处：《中华肝胆外科杂志》2012年第10期740-742,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析不同程度急性胆管炎患者术中胆汁细菌培养的阳性率和细菌谱差异。方法回顾分析自2008年1月至2011年10月期间该院急性胆管炎患者241例，根据日本东京指南标准将患者分为不同等级，全部患者均经手术治疗，术中常规取胆汁送细菌培养，记录胆汁培养结果，数据经SPSS16．0软件分析统计分析。结果该组细菌培养阳性率75．1％，共培养出细菌244株，其中革兰氏阳性菌139株，阴性菌99株，酵母菌6株。前五位细菌分别是大肠埃希菌、粪肠球菌、铅黄肠球菌、铜绿假单胞菌、肺炎克雷伯菌。轻度与重度胆管炎的感染阳性率差异有统计学意义（P〈0．05），但轻度与中度（P=0．141）、中度与重度（P=0．647）急性胆管炎阳性率差异无统计学意义。革兰氏阴性菌在中、重度胆管炎患者分布较革兰氏阳性菌普遍（P〈0．05）。在中、重度急性胆管炎中，多重细菌感染比例较高（P〈0．05）。结论胆道感染细菌仍以大肠杆菌及肠球菌为主，重型急性胆管炎较轻型急性胆管炎细菌培养阳性率高。革兰氏阴性菌在中、重度患者中的分布较阳性菌广，重型急性胆管炎中多重细菌感染较普遍。Objective To analysis the different types of bacteria in patients with a varying se- verity of acute eholangitis. Methods 241 patients who presented with actue cholangitis between Jan 2008 to Oct 2011 to our hospital were retrospectively studied. These patients were divided into three groups according to the Tokyo Guideline. The bile specimens were obtained intraoperatively. The pa- rameters were compared by SPSS 16.0 package program for statistical analysis. Results 75.1 percent of the patients were positive for bacteria in the bile. There were 241 strains of bacterium which includ- ed 139 Gram-positive bacteria, 99 Gram-negative bacteria and 6 strains of microzyme. Escherichia co- li, Enterococcus faecalls, Enterococcus casseliflavus, Pseudomonas aeruginosa and Klebsiella species were the most frequently isolated bacteria. The positive rates for bacteria were significantly different between patients with mild and severe cholangitis （P〈0.05）. There was no significant difference be- tween patients with moderate and mild cholangits （P= 0. 141）, or moderate and severe eholangitis （P=0. 647）. Gram-negative bacteria were more common than Gram-positive bacteria in patients with moderate and severe acute cholangitis （P〈0.05）. In patients with moderate and severe acute cholan- gitis, there was more patients with multiple and mixed bacterial infection. Conclusions Escherichia coll and Enterococcus species were more common in patients with acute cholangitis. The positive rate of bacteria in the bile in severe acute cholangitis was higher than that in mild acute cholangitis. In pa- tients with moderate and severe cholangitis, Gram-negative bacterial infections and multiple and mixed bacterial infections were more common.

关 键 词：胆管炎 胆汁 细菌分型技术 

分 类 号：R446.5[医药卫生—诊断学]