摘要
目的 探讨术后切口脓肿分支杆菌感染的临床病理学特征 ,评价其诊断价值。方法114例手术切口感染均为污染的手术器械消毒液所致 ,经细菌培养及菌种鉴定证实为脓肿分支杆菌。回顾性分析感染组织的病理学特征。结果 114例术后切口感染中累及皮肤和皮下脂肪组织 95例(83 3% ) ,深层肌肉组织 2 1例 (18 4% ) ,腹腔脏器、腹膜和肠系膜 3例 (2 6 % ) ,局部区域淋巴结 13例(11 4% )。病理改变主要为肉芽肿性病变和非特异性慢性化脓性炎症 ,前者见于所有病例 ,后者见于10 0例 (87 7% )。脓肿分支杆菌感染的肉芽肿有化脓性结核样肉芽肿、不典型结核样肉芽肿、结核样肉芽肿三种形态 ,其出现率分别为 75 4%、2 8 1%、5 9 6 % ,同一病例中三种形态的肉芽肿混合存在共18例 (15 8% ) ,但以化脓性结核样肉芽肿为主。 114例行抗酸染色 ,其中 38例 (33 3% )抗酸杆菌阳性。结论 多数脓肿分支杆菌感染的组织学与结核等存在一定的差异 ,结合临床感染病史 ,可为诊断提供一定的线索。
Objective To evaluate the pathological findings of postoperative wound infections by M abscessus Methods Proven sources of infections in 114 patients with postoperative wound infections were contaminated instrument disinfection liquid According to the wound exudates cultivation and bacteriologic identification, the pathogen of postoperative infections was proved M abscessus Pathological features of postoperative wound infections were analyzed retrospectively Results The postoperative wound infections in 114 cases involved cutaneous and subcutaneous tissue 95(83 3%), deep muscular tissue 21(18 4%), local lymph nodes 13(11 4%) and visceral organ, peritoneum and mesentery 3(2 6%) The main pathological appearances were granulomatous lesions and nonspecific chronic pyogenic inflammations The granulomatous lesions include pyogenic tuberculosis like granuloma, atypical tuberculosis like granuloma and tuberculosis like granuloma The three types of granuloma could be seen in the same case and the percentage of three types was 75 4%,28 1%,59 6% respectively 38 cases (33 3%) were showed red mycobacterium at acid fast stain Conclusions The pathological appearances of most postoperative wound infections by M abscessus were more or less different from those of tuberculosis Awareness of the pathologic features of the postoperative wound M abscessus infections will facilitate the diagnosis so that appropriate therapy may be initiated before the disease is far advanced and prevent infection dissemination
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2000年第5期281-283,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
