肛瘘感染患者血清与引流液炎症介质的变化观察  

Observation of the changes of serum and drainage fluid inflammatory mediators in patients with anal fistula infections

作　　者：苗大兴[1] 肖天宝[1] 王开平[1] 张利新[1] 王琴[1] 

机构地区：[1]贵州省中医医院肛肠科,贵州贵阳550001

出　　处：《中华医院感染学杂志》2017年第3期617-620,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅联合基金资助项目(黔科合中药字[2012]LkZ7047)

摘　　要：目的探讨肛瘘感染患者血清及引流液炎症介质的变化,以便为肛瘘的临床诊治提供借鉴和参考依据。方法选取2014年1月-2015年9月医院临床收治45例肛瘘术后感染患者为感染组,另选45例肛瘘术后未发生感染患者为非感染组,对两组患者的红细胞计数、血红蛋白含量、红细胞平均体积、平均血红蛋白量、血红蛋白平均浓度、红细胞分布宽度等血常规指标和IL-1β、IL-6、TNF-α、PGE2、SP、BK等炎症介质指标进行观察和比较。结果感染组患者血红蛋白含量、红细胞平均体积和平均血红蛋白量分别为(80.23±4.32)g/L、(57.93±5.91)fl、(17.23±2.71)pg,显著低于非感染组(123.28±3.12)g/L、(79.34±5.43)fl、(26.93±1.02)pg;感染组患者IL-1β、IL-6、TNF-α、PGE2、SP和BK分别为(2.71±0.33)pg/ml、(9.13±1.28)pg/ml、(1.88±0.23)ng/ml、(176.34±18.34)pg/ml、(6.54±1.34)μg/ml和(7.13±1.02)μg/L均明显的高于非感染组(1.61±0.23)pg/ml、(3.52±0.41)pg/ml、(0.77±0.12)ng/ml、(103.21±11.92)pg/ml、(1.56±0.21)μg/ml、(2.21±0.35)μg/L,且差异有统计学意义(P<0.05);45例肛瘘术后感染患者共检出病原菌88株,其中革兰阴性菌66株占75.00%,革兰阳性菌18株占20.45%,真菌4株占4.55;革兰阴性菌对哌拉西林的敏感度高,对头孢曲松和头孢他啶的耐药性高,革兰阳性菌对克林霉素的敏感度高,对万古霉素和四环素的耐药性高。结论肛瘘感染患者血常规会呈现一定程度的改变趋势,同时感染患者引流液炎症介质水平会显著升高,针对上述指标的检测有利于临床感染的预防和诊治。OBJECTIVE To investigate the changes of inflammatory mediators in serum and drainage fluid of patients with anal fistula infections,so as to provide references for the clinical diagnosis and treatment of anal fistula.METHODS A total of 90 patients with anal fistula who were admitted to our hospital from Jan.2014 to Sep.2015 were chosen as the research objects,and were divided into infection group and non-infection group according to whether or not infected after operation,with 45 cases in each group.The blood routine indexes of red blood cell count,hemoglobin content,mean volume of red blood cells,average hemoglobin,average hemoglobin concentration and red blood cell distribution,and inflammatory mediators of IL-6,TNF-α,PGE2,SP,and BK were observed and analyzed.RESULTS The hemoglobin content,mean volume of red blood cells and average hemoglobin of infection group were（80.23±4.32）g/L,（57.93±5.91）fl and（17.23±2.71）pg,respectively,which were significantly lower than those of non-infection group of（123.28 ± 3.12）g/L,（79.34±5.43）fl,（26.93±1.02）pg.The IL-1β,IL-6,TNF-α,PGE2,SP and BK in infection group were（2.71±0.33）pg/ml,（9.13±1.28）pg/ml,（1.88±0.23）ng/ml,（176.34±18.34）pg/ml,（6.54±1.34）μg/ml and（7.13±1.02）μg/L,which were significantly higher than those of non-infection group of（1.61±0.23）pg/ml,（3.52±0.41）pg/ml,（0.77±0.12）ng/ml,（103.21±11.92）g/ml,（1.56±0.21）μg/ml and（2.21±0.35）μg/L,and the differences were with significant（P〈0.05）.There were 88 strains of pathogens isolated from 45 infected patients with anal fistula,including 66 strains of gram-negative bacteria,18 strains of gram-positive bacteria,and 4strains of fungi,accounting for 75.00%,20.45%,and 4.55%,respectively.Gram-negative bacteria were highly sensitive to piperacillin,and highly resistant to ceftriaxone and ceftazidime,and gram-positive bacteria were highly sensitive to clindamycin,and highly resistant to vancomycin and tetracycline.CONCLUSION The blood r

关 键 词：肛瘘 感染 引流液 炎症介质 

分 类 号：R657.16[医药卫生—外科学]