结肠穿孔所致腹腔感染患者腹水病原菌分布及死亡因素分析  

Distribution of Pathogenic Bacteria and Risk Factors of Death of Ascites in Patients with Abdominal Infection Caused by Colon Perforation

作　　者：王双 WANG Shuang(Department of Critical Care Medicine,Third Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000)

机构地区：[1]南阳医学高等专科学校第三附属医院重症医学科,河南南阳473000

出　　处：《中国肛肠病杂志》2025年第1期29-32,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨结肠穿孔所致腹腔感染患者腹水病原菌分布及死亡因素。方法:选择本院2020年10月至2023年10月收治的结肠穿孔所致腹腔感染患者62例,入院后采集所有患者腹水进行病原菌鉴定,并收集所有患者临床资料、实验室检查指标等,以出院时间为本次观察终点,根据预后情况,将在院内死亡的患者设为死亡组,将存活的患者设为存活组(治愈者、病情稳定后顺利出院者),采用多因素Logistic回归分析结肠穿孔所致腹腔感染患者死亡的相关危险因素。结果:62例结肠穿孔所致腹腔感染患者腹水标本中,共分离出114株病原菌,其中革兰氏阴性菌74株,占比64.91%(74/114),革兰氏阳性菌32株,占比28.07%(32/114),真菌8株,占比7.02%(8/114)。死亡组急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA)及C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)、红细胞分布宽度(RDW)水平均高于存活组(P<0.05)。多因素Logistic回归分析结果显示,APACHEⅡ评分、SOFA评分、CRP、PCT、WBC、RDW均是结肠穿孔所致腹腔感染患者院内死亡的危险因素(P<0.05)。结论:结肠穿孔所致腹腔感染患者腹水病原菌以革兰氏阴性菌为主,其院内死亡与APACHEⅡ评分、SOFA评分、CRP、PCT、WBC、RDW因素密切相关。Objective To investigate the distribution of pathogenic bacteria and risk factors of death of ascites in patients with abdominal infection caused by colon perforation.Methods A total of 62 patients with abdominal infection caused by colon perforation admitted to our hospital from October 2020 to October 2023 were selected and ascites of all patients were collected for pathogen identification.The clinical data and laboratory examination indicators of all patients were collected,with discharge time as the end point of this observation.According to the prognosis,the patients who died in hospital were classified as the death group and and the patients who survived were set as the survival group(those who were cured or those who were stable and discharged successfully).Multivariate Logistic regression was used to analyze the relevant risk factors of death in patients with abdominal infection caused by colon perforation.Results A total of 114 strains of pathogenic bacteria were isolated from the ascite specimens of 62 patients with abdominal infection caused by colon perforation,including 74 strains of Gram-negative bacteria,accounting for 64.91%(74/114),32 strains of Gram-positive bacteria,accounting for 28.07%(32/114),and 8 strains of fungi,accounting for 7.02%(8/114).The acute physiology and chronic health evaluationⅡ(APACHEⅡ),sequential organ failure assessment(SOFA),C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),and red blood cell distribution width(RDW)levels in the death group were higher than those in the survival group(P<0.05).The results of multi-factor Logistic regression analysis showed that APACHEⅡ,SOFA,CRP,PCT,WBC and RDW were all risk factors for in-hospital death in patients with abdominal infection caused by colon perforation(P<0.05).Conclusion Gram-negative bacteria are the main pathogens of ascites in patients with abdominal infection caused by colon perforation.The in-hospital death is closely related to APACHEⅡ,SOFA,CRP,PCT,WBC and RDW.

关 键 词：结肠穿孔 腹腔感染 腹水 病原菌 死亡因素 

分 类 号：R656[医药卫生—外科学] R446.5[医药卫生—临床医学]