口服庆大霉素与逆行性胰胆管造影术后胆道感染的相关性研究  

Study on correlation between oral gentamicin and infections of biliary tract after ERCP

作　　者：刘枭荣 钟征翔[1] 丁春晓[2] 吴晓燕[3] 沈亦钰[1] 陈徐坚[1] 陈飞[4] 

机构地区：[1]嘉兴学院附属第二医院肝胆外科,浙江嘉兴314000 [2]嘉兴学院附属第二医院内镜室,浙江嘉兴314000 [3]嘉兴学院附属第二医院检验科,浙江嘉兴314000 [4]泰山医学院临床医学系,山东泰安271000

出　　处：《中华医院感染学杂志》2015年第7期1538-1540,共3页Chinese Journal of Nosocomiology

基　　金：嘉兴市科技计划基金资助项目(2012AY1071-9)

摘　　要：目的比较逆行胰胆管造影(ERCP)术中所获胆汁及十二指肠液细菌培养结果,前瞻性分析择期行ERCP术后胆道感染与十二指肠液污染之间的关系,并判断术前口服庆大霉素是否能降低术后胆道感染的发生率。方法选取2012年1月-2013年6月因胆总管结石择期行ERCP治疗的患者共210例,将其随机分为对照组115例与试验组95例;试验组于术前30min口服含16IU庆大霉素的灭菌液50ml,对照组于术前30min口服不含庆大霉素的灭菌液50ml,对比两组灭菌效果。结果对照组患者十二指肠液培养阳性与阴性的胆汁培养阳性率分别为10.6%与76.7%,比较差异有统计学意义(P<0.01),试验组患者十二指肠液培养阳性与阴性的胆汁培养阳性率分别为8.6%与76.7%,比较差异有统计学意义(P<0.01);口服含庆大霉素的灭菌液后,十二指肠液及胆汁培养阳性率试验组分别为14.7%及15.8%、对照组分别为26.1%及27.8%,两组比较差异有统计学意义(P<0.05)。结论胆总管结石择期行ERCP的患者术后引起胆道细菌感染与操作过程中十二指肠液的污染有关,术前口服庆大霉素可降低感染发生率。OBJECTIVE To prospectively analyze the relationship between infections of biliary tract after elective ERCP and duodenal fluid contamination by comparing the bacterial culture results of bile and duodenal fluid after ERCP,and judge whether preoperative oral gentamicin can reduce the incidence of postoperative infections of biliary tract.METHODS Totally 210 patients with choledocholithiasis receiving selective ERCP during Jan.2012 to Jun.2013 were randomly grouped into the experimental group（95cases）and the control group（115cases）.Patients in the experimental group received oral administration of 50 ml sterile water containing 16 IU gentamicin at30 min before ERCP,while the control group received oral administration of 50 ml sterile water without gentamicin at 30 min before ERCP.The sterile effect in the two groups was compared.RESULTS The positive rate of bile culture for patients with positive vs.negative duodenal juice culture was 10.6% vs.76.7%in the control group and 8.6% vs.76.7%in the experimental group,the differewce was significant（P〈0.01）.After oral administration of sterile water containing gentamicin,the positive rate for duodenal juice culture and bile culture was 14.7%and 15.8%in the experimental group,26.1% and 27.8%in the control group,the differenle was significant（P〈0.05）.CONCLUSIONInfection of biliary tract in patients with choledocholithiasis undergoing elective ERCP is associated with duodenal juice contamination,preoperative oral gentamicin can reduce the incidence of infections.

关 键 词：逆行性胰胆管造影 预防感染 庆大霉素 

分 类 号：R978.1[医药卫生—药品]