摘要
目的加强临床医师对重型再生障碍性贫血合并肛周脓肿的认识,提高治愈率。方法回顾性分析1例重型再生障碍性贫血合并肛周脓肿患者的临床资料、临床表现、B超、病原学培养结果及治疗经过,并结合文献复习。结果该例患者入院后肛周细菌培养为大肠埃希菌,给予头孢哌酮/他唑巴坦和依替米星抗感染,患者症状好转、肛周脓肿范围缩小,治疗7d后自动出院;两周后患者因肛周疼痛再次入院,应用原抗感染方案治疗无效,再次行肛周细菌培养,结果为弗氏柠檬酸杆菌和屎肠球菌,根据药敏结果给予美罗培南和替考拉宁抗感染,同时配合中药坐浴、升白细胞、输血等治疗,两周后肛周脓肿得以完全治愈。结论及时正确选用抗菌药物,配合中药坐浴及积极支持治疗可提高重型再生障碍性贫血患者肛周脓肿的治愈率。
OBJECTIVE To enhance the clinicians＇ cognition of severe aplastic anemia complicated with perianal abscess so as to raise the cure rate.METHODS A retrospective survey was conducted for 1case of severe aplastic anemia complicated with perianal abscess,including the clinical data,clinical manifestations,B-ultrasound,results of etiological culture,and treatment process,with the review of literature accompanied.RESULTS The Escherichia coli strains were cultured from this patient after the admission,the symptom was improved and the scope of perianal abscess was reduced after the treatment with cefoperazone-tazobactam and etimicin,the patient was automatically discharged after the treatment for 7days and was readmitted due to the perianal pain,the previous anti-infection treatment was ineffective,the perianal bacterial culture was carried out for the second time,the Citrobacter freundii and Enterococcus faecium were isolated,meropenem and teicoplanin were used for anti-infection treatment based on the results of the drug susceptibility testing,accompanied by the hip bath of TCM,elevation of white blood cells,and blood transfusion,and the perianal abscess was completely cured after the treatment for two weeks.CONCLUSION The reasonable use of antibiotics accompanied by the hip bath of TCM and active supportive treatment can raise the cure rate of the perianal abscess in the patient with severe aplastic anemia.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第21期4957-4958,共2页
Chinese Journal of Nosocomiology
基金
湖南省自然科学基金资助项目(2013SK3102)
关键词
重型再生障碍性贫血
肛周脓肿
抗菌药物
中药
Severe aplastic anemia
Perianal abscess
Antibiotic
Traditional Chinese medicine
