摘要
目的探讨肛周脓肿合并2型糖尿病患者临床特点及感染致病菌药物敏感性。方法选取2015年1月至2018年6月于本院接受治疗的90例肛周脓肿患者为研究对象,按照患者是否患有2型糖尿病分为观察组(合并2型糖尿病)和对照组(未合并2型糖尿病)。统计两组患者脓肿类型并计算构成比,手术前对脓肿组织穿刺抽取脓液并行细菌培养,对感染致病菌进行种类鉴定,并对不同抗菌药物进行药物敏感性试验。结果观察组括约肌间脓肿、皮下囊肿、直肠黏膜下脓肿所占比例显著高于对照组,同时肛提肌上脓肿、坐骨直肠间隙脓肿所占比例显著低于对照组,差异有统计学意义(P<0.05)。90例患者共分离出感染致病菌142株,其中革兰阴性菌104株占比73.24%,革兰阳性菌38株占比26.76%;革兰阴性菌中以大肠埃希菌、脆弱拟杆菌为主,革兰阳性菌以链球菌属为主。38株革兰阳性菌对甲氧苄啶、克林霉素、环丙沙星、四环素抗菌药物耐药率较高,对青霉素G、头孢唑林、庆大霉素、红霉素抗菌药物敏感率较高;其中甲氧苄啶耐药率最高(94.74%),青霉素G敏感率最高(92.11%)。104株革兰阴性菌对头孢唑林、阿莫西林、头孢呋辛、头孢西丁、妥布霉素、头孢吡肟抗菌药物耐药率较高,其中头孢唑林耐药率最高(88.46%),对头孢哌酮敏感率最高(62.50%)。结论肛周脓肿合并2型糖尿病患者脓肿类型高发于括约肌间脓肿、皮下囊肿、直肠黏膜下脓肿,感染致病菌以革兰阴性菌为主,感染致病菌对多种抗菌药物耐药率较高,临床治疗时应进行充分的感染致病菌药物敏感性分析,选择敏感率较高的抗菌药物进行治疗。
Objective To explore the clinical characteristics, pathogenic bacteria and drug sensitivity of perianal abscess complicated with type 2 diabetes mellitus. Methods A total of 90 cases of perianal abscess treated in our hospital from January 2015 to June 2018 were selected as the subjects. The patients were divided into the observation group(with type 2 diabetes mellitus) and the control group(without type 2 diabetes mellitus) according to whether the patients were complicated with type 2 diabetes mellitus. The type of abscess in the two groups and the ratio of the composition were calculated. The abscess tissue was extracted before the operation, and the bacteria were cultured in parallel. The pathogenic bacteria were identified and the drug sensitivity test of different antibiotics was carried out. Results The proportion of the intersphincter abscess, subcutaneous cyst and submucosal abscess in the observation group was significantly higher than that of the control group, while the proportion of the anorectal muscle abscess and the abscess of the space of the sciatic rectum was significantly lower than that of the control group(P<0.05). A total of 142 strains of infection pathogenic bacteria were isolated from 90 cases, of which Gram-negative bacteria accounted for 73.24%, Gram-positive bacteria accounted for 26.76%, and Gram-negative bacteria were mainly Escherichia coli and fragile bacillus, and Gram-positive bacteria were mainly Streptococcus. The resistance rate of 38 Gram-positive bacteria to trimethoprim, clindamycin, ciprofloxacin and tetracycline antibiotics was higher. The susceptibility to penicillin G, cefazolin, gentamicin and erythromycin was higher. The resistance rate of trimethoprim was the highest, which was 94.74%, and penicillin G sensitivity was the highest, which was 92.11%. The resistance rate of 104 Gram-negative bacteria to cefazolin, amoxicillin, cefuroxime, cefoxitin, tobramycin and cefepime was higher. The drug resistance rate of cefazolin was the highest, which was 88.46%, and the sens
作者
张学进
ZHANG Xue-jin(Hospital of Traditional Chinese Medicine of Yucheng County, Shangqiu, Henan 476300, China)
出处
《青岛医药卫生》
2019年第4期251-255,共5页
Qingdao Medical Journal
关键词
肛周脓肿
2型糖尿病
临床特点
感染致病菌
药物敏感性
Perianal abscess
Type 2 diabetes mellitus
Clinical characteristics
Pathogenic bacteria
Drug sensitivity
