重症急性胰腺炎并发胰腺感染的危险因素分析及防治措施  

Risk Factors of Pancreatic Infections in Patients with Severe Acute Pancreatitis and Preventive Countermeasures

作　　者：李斌杰[1] 赵二鹏[2] 郑云[2] 李岩[2] 崔乃强[2] 

机构地区：[1]中国人民武装警察部队学院医院,廊坊065000 [2]天津市南开医院第二外科,天津300100

出　　处：《中国中西医结合外科杂志》2014年第2期111-113,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:分析重症急性胰腺炎患者胰腺及胰周坏死的危险因素,探讨防治措施,为临床工作提供帮助。方法:对120例重症急性胰腺炎患者采取治疗后观察患者发生感染的情况,进而对并发胰腺感染的危险因素进行分析。结果:120例重症急性胰腺炎患者中并发胰腺感染者51例,感染率为42.50%,其发生率与患者低氧血症、血淀粉酶、血钙、机械通气、APACHEⅡ评分、糖尿病史等方面有统计学意义(P<0.05);患者胰腺坏死组织和腹水经病原菌培养得到85株病原菌,构成比前3位的病原菌分别为阴沟肠杆菌、铜绿假单胞菌和金黄色葡萄球菌。结论:低氧血症、机械通气、APACHEⅡ评分、糖尿病史是重症急性胰腺炎患者并发胰腺感染的危险因素。Objective To analyze the risk factors of pancreatic infections in patients with severe acute pan-creatitis（SAP） and investigate the prevention and control measures of clinical treatment. Methods One hun-dred and twenty patients with SAP received active treatment after taking prevention measures,and the risk fac-tors for the concurrent pancreatic infections were analyzed. Results Of all 120 patients with SAP investigat-ed,the pancreatic infections occurred in 51 patients with the incidence rate of 42.50%. There was statistically significance between the incidence of pancreatic infections and hypoxemia,serum amylase,serum calcium,me-chanical ventilation,APACHEⅡ score and diabetes history （P＆lt;0.05）. All 85 strains of microorganisms were cultured from necrotic pancreatic tissue or ascites,among which the top three species were Enterobacter cloacae, Pseudomonas aeruginosa and Staphylococcus aureus. Conclusion The hypoxemia,fasting time,mechanical ventilation,APACHE Ⅱ score,diabetes history are the risk factors leading to pancreatic infections in patients with SAP.

关 键 词：重症急性胰腺炎 感染 危险因素 预防措施 

分 类 号：R657.51[医药卫生—外科学]