胰十二指肠切除术后感染的病原学与危险因素和预防对策  

Etiology,risk factors,and prevention countermeasures for infections after pancreaticoduodenectomy

作　　者：赵建琴[1] 危少华[1] 叶振宇[1] 吴钟凌 赵丽[1] ZHAO Jian-qin WEI Shao-hua YE Zhen-yu WU Zhong-ling ZHAO Li(The Second Hospital Affiliated to Suzhou University, Suzhou, Jiangsu 215000, China)

机构地区：[1]苏州大学附属第二医院普外科,江苏苏州215000

出　　处：《中华医院感染学杂志》2017年第12期2733-2736,共4页Chinese Journal of Nosocomiology

基　　金：江苏省自然科学基金资助项目(BK20160338)

摘　　要：目的探讨胰十二指肠切除术后感染的病原学及危险因素和可行的预防对策。方法选择医院2014年7月-2016年3月收治77例行胰十二指肠切除术的患者,行抽血培养分析对术后感染患者病原学特点及其发生的危险因素,并找出相应的预防对策。结果对本研究36例出现感染患者行抽血培养共培养出病原菌47株,其中革兰阴性菌39株,革兰阳性菌为8株;并发现手术持续时间、术中出血量、术后发生胰瘘、术前白蛋白、术前感染病史均为胰十二指肠切除术术后感染的独立危险因素(P<0.05)。结论手术持续时间、术中出血量、术后胰瘘、术前白蛋白、术前感染病史均是胰十二指肠切除术后感染的危险因素,应及时发现并处理,做好预防对策。OBJECTIVE To explore the etiology,risk factors,and prevention countermeasures for infections after pancreaticoduodenectomy.METHODS A total of 77 patients who underwent pancreaticoduodenectomy in the hospital form Jul 2014 to Mar 2016 were enrolled in the study,then the blood culture was carried out,the etiological characteristics and risk factors for postoperative infection were observed,and the corresponding prevention countermeasures were put forward.RESULTS Totally 47 strains of pathogens were isolated from the blood specimens of 36 patients who had the infections,including 39 strains of gram-negative bacteria and 8 strains of gram positive bacteria.It was concluded that the independent risk factors for the postoperative infection in the patients undergoing pancreaticoduodenectomy included operation duration,intraoperative bleeding volume,postoperative pancreatic fistula,preoperative albumin,and history of preoperative infectious diseases （P〈0.05）.CONCLUSION The risk factors for the postoperative infection in the patients undergoing pancreaticoduodenectomy include operation duration,intraoperative bleeding volume,postoperative pancreatic fistula,preoperative albumin,and history of preoperative infectious diseases.It is necessary to detect and treat in a timely manner and take the prevention countermeasures.

关 键 词：胰十二指肠切除术 术后感染 病原学 危险因素 预防 

分 类 号：R735[医药卫生—肿瘤]