重症急性胰腺炎患者腹腔感染病原菌分布与危险因素分析  

Analysis of pathogens and risk factors for abdominal infections in patients with severe acute pancreatitis

作　　者：王琼[1] 杨晓钟[1] 戴伟杰[1] 张娟[1] 周静芳[1] 

机构地区：[1]南京医科大学附属淮安市第一人民医院消化科,江苏淮安223300

出　　处：《中华医院感染学杂志》2015年第23期5346-5348,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81070655)

摘　　要：目的探讨重症急性胰腺炎(SAP)患者腹腔感染病原菌特点及危险因素,为临床降低重症急性胰腺炎合并感染提供参考依据。方法回顾性分析2010年1月-2014年12月医院收治的84例重症急性胰腺炎患者临床资料,分析腹腔感染患者病原菌分布,采用logistic回归分析感染的危险因素,数据采用SPSS 19.0软件进行统计分析。结果 84例重症急性胰腺炎患者中发生腹腔感染患者33例,感染率为39.29%;共检出60株病原菌,以革兰阴性菌为主,共41株占68.34%;logistic回归分析显示,禁食时间、肠功能障碍时间、机械通气、合并多器官功能障碍综合征、合并低氧血症、胰腺CT显示坏死等因素是重症急性胰腺炎患者发生腹腔感染的独立危险因素(P<0.05)。结论重症急性胰腺炎患者并发腹腔感染危险因素较多,需采取相应措施,降低医院感染率。OBJECTIVE To explore the pathogens and risk factors of abdominal infections in patients with severe a- cute pancreatitis （SAP）, so as to provide evidence for reducing the combined infections in patients with severe a- cute pancreatitis. METHODS A total of 84 patients with severe acute pancreatitis from Jan. 2010 to Dec. 2014 in our hospital were selected and those clinical data were retrospective analyzed. There were 33 cases of abdominal in- fections and 51 cases of non-infected patients. The distribution of pathogens was analyzed. The risk factors for ab- dominal infections in severe acute pancreatitis were analyzed by logistic regression analysis. SPSS was explored to statistically analyze the data. RESULTS Totaly 33 patients complicated with abdominal infection among the 84 pa- tients with severe acute pancreatitis and the infections rate was 39.29%. A total of 60 pathogens were detected, including 41 strains （68. 34%） of gram-negative bacteria, dominating the majority. The univariate analysis and multivariate logistic regression analysis showed that the fasting time, the time of intestinal dysfunction, mechani- cal ventilation, multiple organ dysfunction syndrome, hypoxemia, pancreatic necrosis showed by CT were inde- pendent risk factors for patients with severe acute pancreatitis who occur abdominal infections （P 〈 0. 05）. CONCLUSION The results show that risk factors for abdominal infections in patients with severe acute pancreatitis are complex. It is necessary to take appropriate measures to reduce hospital infection rates.

关 键 词：重症急性胰腺炎 病原菌 感染 危险因素 

分 类 号：R378[医药卫生—病原生物学]