重症急性胰腺炎早期胰液细菌培养的临床意义  

Bacterial culture of pancreatic juice in early stage of severe acute pancreatitis

作　　者：赵成思 姚维杰 彭波 杨亚飞 兰柱 张兴智 王佐正[2] Zhao Chengsi;Yao Weijie;Peng Bo;Yang Yafei;Lan Zhu;Zhang Xingzhi;Wang Zuozheng(Ningxia Medical University,Yinchuan 750004,China;Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of General Surgery,People's Hospital of Yuanzhou District,Guyuan 756000,China)

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院肝胆外科,银川750004 [3]宁夏原州区人民医院普外科,固原756000

出　　处：《中华普通外科杂志》2022年第5期348-353,共6页Chinese Journal of General Surgery

基　　金：宁夏回族自治区重点研发计划重点项目 (2020BEG02002,2021BEG03042);宁夏回族自治区技术创新引导计划科技惠民项目 (2021CMG03013);宁夏医科大学总医院(自治区临床医学研究中心)开放课题。

摘　　要：目的:探讨重症急性胰腺炎(severe acute pancreatitis,SAP)患者胰液中细菌分布特点及临床意义。方法:回顾性分析2019年1月1日至2020年6月30日在宁夏医科大学总医院肝胆外科接受ERCP治疗且行胰液细菌培养的SAP患者的病例资料。结果:共纳入97例患者。97份胰液标本中46例(47.42%)培养出病原菌,46例阳性标本中分离出菌株71株,革兰阴性菌43株(60.56%),革兰阳性菌26株(36.62%),真菌2株(2.82%)。培养阳性组患者的C反应蛋白(C-reactive protein,CRP)、D-二聚体、Balthazar CT评分等都高于培养阴性组(均 P<0.05)。培养阳性组患者并发症及胰腺感染的发生率也明显较高(均 P<0.05)。 结论:SAP患者早期胰液细菌培养阳性率较高,革兰阴性菌最多,其次是革兰阳性菌和真菌。Objective To investigate the distribution,drug resistance and clinical significance of bacteria and fungi in pancreatic juice of patients with severe acute pancreatitis(SAP).Methods Data of patients with severe acute pancreatitis receiving ERCP treatment and pancreatic juice bacterial culture at Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University from Jan 2019 to Jun 2020 were retrospectively analyzed.Results A total of 97 patients were included.Pathogens were isolated from 46(47.42%)pancreatic juice samples,with 71 strains including 43(60.56%)gram negative bacteria,26(36.62%)gram positive bacteria,and 2(2.82%)fungi.The C-reactive protein(CRP),D-dimer and Balthazar CT Score in the culture positive group were higher than those in the culture negative group(P<0.05).The incidence of complications and pancreatic infection in the culture positive group was also significantly higher(P<0.05).Conclusions The positive rate of pancreatic juice bacterial culture in the early stage of severe acute pancreatitis is high,in which Gram-negative bacteria are most common,followed by Gram-positive bacteria and fungi.The presence of pathogens in pancreatic juice predicts ensuing infections.

关 键 词：胰腺炎 急性坏死性 感染 病原菌 

分 类 号：R657.51[医药卫生—外科学]