重症急性胰腺炎并发胰腺感染的危险因素分析及预防  

Risk factors for severe acute pancreatitis complicated by pancreatic infections and preventive measures

作　　者：李智琳 马立辉[2] 

机构地区：[1]唐山市医保局医审二处,河北唐山063000 [2]承德医学院附属医院肿瘤外科,河北承德067000

出　　处：《中华医院感染学杂志》2012年第22期5020-5022,共3页Chinese Journal of Nosocomiology

摘　　要：目的对重症急性胰腺炎并发胰腺感染的危险因素进行分析,制定相应的预防措施。方法对152例重症急性胰腺炎患者采取治疗和预防感染措施后观察患者的感染情况,对并发胰腺感染的危险因素进行分析。结果152例重症急性胰腺炎患者中并发胰腺感染64例,感染率42.11%,其发生率与患者低氧血症、禁食时间、机械通气、APACHEⅡ评分、抗菌药物的使用和病程方面存在明显相关(P<0.01);患者胰腺坏死组织和腹水经病原菌培养后得到病原菌81株,构成比居前3位病原菌依次为阴沟肠杆菌、铜绿假单胞菌、金黄色葡萄球菌。结论低氧血症、禁食时间、机械通气、APACHEⅡ评分、抗菌药物的使用和病程是重症急性胰腺炎患者并发胰腺感染的危险因素;改善呼吸功能和肠道微循环,尽快恢复饮食并合理应用抗菌药物是预防胰腺感染的有效措施。OBJECTIVE To study the risk factors and preventive measures of severe acute pancreatitis complicated by pancreatic infections so as to formulate appropriate prevention measures.METHODS A total of 152 patients with severe acute pancreatitis were received the treatment after taking prevention measures,and the risk factors for the concurrent pancreatic infections were analyzed.RESULTS Of 152 patients with severe acute pancreatitis investigated,the pancreatic infections occurred in 64 patients with the incidence rate of 42.11%.There was significant correlation between the incidence of pancreatic infections and hypoxemia,fasting time,mechanical ventilation,APACHEⅡ score,application of antibiotics as well as disease course（P0.01）.And totally 81 strains of microorganisms were cultured from patients′necrotic pancreatic tissue or ascites,among which the top three species were in turn as follows： Enterobacter cloacae,Pseudomonas aeruginosa and Staphylococcus aureus.CONCLUSION The hypoxemia,fasting time,mechanical ventilation,APACHEⅡ score,application of antibiotics and disease course are the risk factors leading to the pancreatic infections in the patients with severe acute pancreatitis.To improve respiratory function and intestinal microcirculation,resume the diet and use antibiotics can prevent the pancreatic infections effectively.

关 键 词：重症急性胰腺炎 胰腺感染 危险因素 预防措施 

分 类 号：R181.32[医药卫生—流行病学]