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Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis 被引量:17
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作者 Jiong-Di Lu Feng Cao +3 位作者 Yi-Xuan Ding Yu-Duo Wu Yu-Lin Guo Fei Li 《World Journal of Gastroenterology》 SCIE CAS 2019年第34期5162-5173,共12页
BACKGROUND Acute pancreatitis(AP)is a common acute abdominal disease worldwide,and its incidence rate has increased annually.Approximately 20%of AP patients develop into necrotizing pancreatitis(NP),and 40%to 70%of NP... BACKGROUND Acute pancreatitis(AP)is a common acute abdominal disease worldwide,and its incidence rate has increased annually.Approximately 20%of AP patients develop into necrotizing pancreatitis(NP),and 40%to 70%of NP patients have infectious complications,which usually indicate a worse prognosis.Infection is an important sign of complications in NP patients.AIM To investigate the difference in infection time,infection site,and infectious strain in NP patients with infectious complications.METHODS The clinical data of AP patients visiting the Department of General Surgery of Xuanwu Hospital of Capital Medical University from January 1,2014 to December 31,2018 were collected retrospectively.Enhanced computerized tomography or magnetic resonance imaging findings in patients with NP were included in the study.Statistical analysis of infectious bacteria,infection site,and infection time in NP patients with infectious complications was performed,because knowledge about pathogens and their antibiotic susceptibility patterns is essential for selecting an appropriate antibiotic.In addition,the factors that might influence the prognosis of patients were analyzed.RESULTS In this study,539 strains of pathogenic bacteria were isolated from 162 patients with NP infection,including 212 strains from pancreatic infections and 327 strains from extrapancreatic infections.Gram-negative bacteria were the main infectious species,the most common of which were Escherichia coli and Pseudomonas aeruginosa.The extrapancreatic infection time(9.1±8.8 d)was earlier than the pancreatic infection time(13.9±12.3 d).Among NP patients with early extrapancreatic infection(<14 d),bacteremia(25.12%)and respiratory tract infection(21.26%)were predominant.Among NP patients with late extrapancreatic infection(>14 d),bacteremia(15.94%),respiratory tract infection(7.74%),and urinary tract infection(7.71%)were predominant.Drug sensitivity analysis showed that P.aeruginosa was sensitive to enzymatic penicillins,thirdand fourth-generation cephalosporins,a 展开更多
关键词 NECROTIZING PANCREATITIS extrapancreatic infection PATHOGENIC BACTERIA Drug sensitivity test
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胰腺外感染对急性胰腺炎并发症和预后的影响 被引量:2
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作者 黄海龙 周蓉 +1 位作者 王娟 吴应冬 《中国实验诊断学》 2021年第6期836-839,共4页
目的探讨胰腺外感染(Extrapancreatic infection,EPI)对急性胰腺炎(Acute pancreatitis,AP)并发症和预后的影响。方法回顾性分析2018年4月至2019年10月南通大学附属海安医院收治的182例AP患者的临床资料,统计EPI发生情况,对比有无并发EP... 目的探讨胰腺外感染(Extrapancreatic infection,EPI)对急性胰腺炎(Acute pancreatitis,AP)并发症和预后的影响。方法回顾性分析2018年4月至2019年10月南通大学附属海安医院收治的182例AP患者的临床资料,统计EPI发生情况,对比有无并发EPI患者在胰腺坏死、持续性器官功能衰竭、死亡方面的差异,分析导致患者死亡的相关因素。结果本组57例(31.3%)AP患者并发EPI,其中45例(24.7%)AP患者并发1种EPI、10例(5.5%)并发2种EPI、2例(1.1%)并发3种EPI,具体包括:菌血症27例(14.8%)、肺部感染19例(10.4%)、尿路感染14例(7.7%)和导管相关感染11例(6.0%)。并发EPI患者发生胰腺坏死(35.1%vs 12.8%)、持续性器官衰竭(29.8%vs 6.4%)和死亡(24.6%vs 3.2%)的比例较高,差异均具有统计学意义(P<0.05)。在各种类型EPI中,只有菌血症(25.9%vs 4.5%)和肺部感染(47.4%vs 3.1%)与较高的死亡率相关(P<0.05)。多因素Logistic回归分析发现,持续性器官衰竭(OR:3.175,95%CI:1.658-5.724,P=0.003)、肺部感染(OR:2.049,95%CI:1.467-3.495,P=0.011)和菌血症(OR:1.864,95%CI:1.549-2.858,P=0.034)是AP患者死亡的独立危险因素。结论 EPI尤其是菌血症和肺部感染在一定程度上增加了AP患者并发症和死亡的风险。 展开更多
关键词 急性胰腺炎 胰腺外感染 菌血症 肺部感染
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急性坏死性胰腺炎患者术后结肠瘘发生的影响因素
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作者 徐雪华 马玉珍 +1 位作者 王旻静 王媛 《中国实用医刊》 2022年第13期16-19,共4页
目的探讨急性坏死性胰腺炎术后并发结肠瘘的相关因素。方法抽取2019年10月至2021年10月河南省人民医院肝胆胰腺外科收治的250例急性坏死性胰腺炎手术患者作为研究对象,跟踪调查记录其术后并发结肠瘘的情况,将术后继发结肠瘘的15例患者... 目的探讨急性坏死性胰腺炎术后并发结肠瘘的相关因素。方法抽取2019年10月至2021年10月河南省人民医院肝胆胰腺外科收治的250例急性坏死性胰腺炎手术患者作为研究对象,跟踪调查记录其术后并发结肠瘘的情况,将术后继发结肠瘘的15例患者设为发生组,未并发结肠瘘的235例患者设为未发生组,对比两组患者的基本信息及相关检查指标数据,运用Logistic单因素回归分析法研究急性坏死性胰腺炎术后并发结肠瘘的相关影响因素。结果发生组与未发生组在术前是否存在器官衰竭、是否侵染胰周、手术时机的选择等方面比较差异有统计学意义(P<0.05),其他基础资料比较差异未见统计学意义(P>0.05)。Logistic单因素回归分析结果显示,术前存在器官衰竭、侵染胰周及早期手术介入是影响急性胰腺炎患者术后并发结肠瘘的相关因素(OR>1,P<0.05)。结论结肠瘘是急性坏死性胰腺炎术后最为严重的并发症,其主要影响因素为患者术前是否存在器官衰竭、术前病情是否出现胰外侵染以及手术时机选择。 展开更多
关键词 急性坏死性胰腺炎 结肠瘘 器官衰竭 胰外侵染 手术时机选择
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