摘要
目的探讨引起胰腺术后腹腔感染的主要致病菌以及腹腔感染与术后胰瘘的关系。方法分析北京协和医院2005年8月至2006年6月收治的60例胰腺疾病病人临床资料。术后通过取样导管收集腹腔内手术区域的引流液,进行细菌学培养及鉴定,用以分析腹腔引流液细菌培养结果,分析临床腹腔感染与胰瘘之间的关系。结果60例胰腺疾病术后病人中,腹腔引流液细菌培养的阳性率在术后2h、1d、3d、7d和14d分别为2.7%(1/37)、27.3%(15/55)、45.8%(27/59)、70.3%(26/37)和87.5%(14/16)。60例病人手术区域引流液共进行了204次培养,获得67株细菌,最常见的为MRSCoN(耐甲氧西林凝固酶阴性葡萄球菌)16.4%,其次为粪肠球菌14.9%和MRSA(耐甲氧西林金黄色葡萄球菌)11.9%。17例在术后10d内发生临床腹腔感染,22例发生胰瘘。利用χ2检验和Logistic回归分析发现:术后胰瘘发生与术后第1、3天腹腔引流液细菌培养阳性不相关;而与10d内临床腹腔感染相关。结论胰腺术后腹腔引流液细菌培养阳性率随引流时间延长而迅速上升,培养中无专性厌氧菌。术后胰瘘与术后引流液细菌培养结果不相关,而与术后临床腹腔感染相关。
Objective The aim of this study was to determine the bacterial spectrum of abdominal infection after pancreatic resections and the relationships between pancreatic fistulae and abdominal infections. Methods Intraperitoneal drainage fluid was collected through sampling tubes and bacteriological examinations were performed. The clinical characters of patients and the duration of intraperitoneal drainage were recorded. Results For 60 patients, positive cultures of drainage fluid were 2.7% （ 1/37 ）, 27.27% （ 15/55 ）, 45.76% （ 27/59 ）, 70. 27% （ 26/37 ） and 87.5% （ 14/16 ） in POD0,POD1, POD3 ,POD7 and POD14. Sixty-seven stems of bacteria were identified. The most dominant bacteria were MRSCoN 16. 4% （11/67）,E. faecalis 14. 9% （10/67） and MRSA11.9% （8/67）. Abdominal infections were found in 17 cases during 10 days after operations, and 22 patients suffered from pancreatic fistulae with intraperitoneal drainage more than 14 days. χ^2 statistics and Binary Logistic Regression shows that intraperitoneal infections during 10 days after operations was potential risk factors for pancreatic fistulae, while positive culture of drainage fluid in P1D and P3D were not related with pancreatic fistulae. Conclusion The incidence of positive culture of drainage fluids increased with the duration of postoperative abdominal drainage. Pancreatic fistulae were not related with abdominal drainage fluid cultures, but with clinical abdominal infections.
出处
《中国实用外科杂志》
CSCD
北大核心
2008年第1期53-55,共3页
Chinese Journal of Practical Surgery
关键词
胰瘘
细菌培养
腹腔感染
引流液
pancreatic fistula
bacterial culture
abdominal infection
drainage fluid
