肠外瘘合并腹腔感染患者血清炎性因子水平变化及腹腔穿刺液中病原菌分布情况  

Changes of serum inflammatory factors and distribution of pathogens in abdominal puncture fluid in patients with enterocutaneous fistula complicated with abdominal infection

作　　者：肖曙 熊颖[1] 郭芳 卢晓明[2] 张万里[2] 肖勇[2] Xiao Shu;Xiong Ying;Guo Fang;Lu Xiaoming;Zhang Wanli;Xiao Yong(Department of Gastroenterology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院消化内科,武汉430022 [2]华中科技大学同济医学院附属协和医院消化肿瘤外科,武汉430022

出　　处：《中国医学前沿杂志（电子版）》2020年第9期145-148,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨肠外瘘合并腹腔感染患者血清炎性因子水平变化及腹腔穿刺液中病原菌分布情况。方法将2015年3月至2018年12月于华中科技大学同济医学院附属协和医院收治的136例肠外瘘合并腹腔感染患者纳入研究组,选择该院同期136例健康体检者纳入对照组。分析研究组患者腹腔穿刺液中病原菌分布情况,比较两组研究对象血清炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、降钙素原(procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)、白介素-6(interleukin-6,IL-6)、白介素-10(interleukin-10,IL-10)]水平和研究组患者治疗前后炎性因子水平。结果研究组患者腹腔穿刺液中共分离出246株病原菌,其中151株(61.38%)革兰氏阴性菌,85株(34.55%)革兰氏阳性菌,10株(4.06%)真菌。研究组患者血清TNF-α、PCT、CRP、IL-6、IL-10水平均显著高于对照组(均P<0.05),且研究组患者治疗后上述血清炎性因子水平均显著低于治疗前(均P<0.05)。结论肠外瘘合并腹腔感染患者腹腔穿刺液中病原菌主要为革兰氏阴性菌,应针对病原菌种类合理用药,可将炎性因子作为评估肠外瘘合并腹腔感染患者病情的参考指标。Objective To investigate the changes of serum inflammatory factors and distribution of pathogens in abdominal puncture fluid in patients with enterocutaneous fistula complicated with abdominal infection.Method From March 2015 to December 2018,136 patients with enterocutaneous fistula complicated with abdominal infection treated in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology were included in study group,and 136 healthy subjects in the same period were selected as control group.The distribution of pathogens in the peritoneal puncture fluid of the patients in study group was analyzed,and the levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α),procalcitonin(PCT),C reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10)]in the two groups were compared,and the inflammatory factors were compared before and after treatment in study group.Result A total of 246 strains of pathogenic bacteria in abdominal puncture fluid were isolated from patients in study group,including 151 strains(61.38%)of Gram negative bacteria,85 strains(34.55%)of Gram positive bacteria and 10 strains(4.06%)of fungi.The serum levels of TNF-α,PCT,CRP,IL-6 and IL-10 in study group were significantly higher than those in control group(all P<0.05),and the levels of these inflammatory factors in study group after treatment were significantly lower than those before treatment(all P<0.05).Conclusion The pathogens in the abdominal puncture fluid of patients with enterocutaneous fistula complicated with abdominal infection are mainly Gram negative bacteria.Rational use of drugs should be aimed at the types of pathogenic bacteria,and inflammatory factors can be used as a reference index to evaluate the condition of patients with enterocutaneous fistula complicated with abdominal infection.

关 键 词：肠外瘘 腹腔感染 炎性因子 病原菌 

分 类 号：R574[医药卫生—消化系统]