CAJ | 학술논문

目的研究重症急性胰腺炎继发胰腺感染的危险因素和感染特点.方法采用1∶1配对病例对照研究,收集49对病例(SPI组)和对照(NSPI组),危险因素筛选用条件Logistic回归分析.结果 (1)单因素分析中筛出7项危险因素,其中低蛋白血症时间长、中心静脉置管时间长、激素经多因素分析与继发的胰腺感染相关.(2)SPI组胰腺脓肿居首位;胰腺感染发生在2周内的占22.5%,4周及其以后的占71.4%.(3)SPI组总共培养出病原菌81株(肠道菌占43.2%),革兰阴性菌、革兰阳性菌、真菌分别占55.6%、27.2%、17.3%.结论长时间低蛋白血症、长时间中心静脉置管和激素是继发胰腺感染的独立危险因素.革兰阴性菌是继发胰腺感染的常见病原菌.
목적 연구중증급성이선염계발이선감염적위험인소화감염특점.방법 채용1∶1배대병례대조연구,수집49대병례(SPI조)화대조(NSPI조),위험인소사선용조건Logistic회귀분석.결과 (1)단인소분석중사출7항위험인소,기중저단백혈증시간장、중심정맥치관시간장、격소경다인소분석여계발적이선감염상관.(2)SPI조이선농종거수위;이선감염발생재2주내적점22.5%,4주급기이후적점71.4%.(3)SPI조총공배양출병원균81주(장도균점43.2%),혁란음성균、혁란양성균、진균분별점55.6%、27.2%、17.3%.결론 장시간저단백혈증、장시간중심정맥치관화격소시계발이선감염적독립위험인소.혁란음성균시계발이선감염적상견병원균.
Objective To explore risk factors and infection characteristics of secondary pancreatic infection in severe acute pancreatitis(SAP). Methods A clinical data of 49 patients with secondary pancreatic infection in severe acute pancreatitis(SPI group)were matched with 49 patients without infeetion in severe acute pancreatitis(NSPI group)between January 2003 and December 2005. The two groups were analyzed by a case-control study. Conditional Logistic regression model univariate and multivariate were used to screen out risk factors. The types of infection,the peak infection and the bacteria spectrum were analyzed in SPI group.Results (1)In univariate Logistic regression analysis,7 factors including continuous hypoalbuminemia,prolonged time of central venous catheter,usage of hormone,high APACHE Ⅱ scores,multi-antibiotics,intestine dyrsfunction and continuous hyperglycemia were selected out.Moreover,the first three were statistically significant in multivariate Logistic regression analysis.(2)Pancreatic abscess ranked first in SPI group.Of all the pancreatic infection,22.5%occurred within two weeks and 71.4% occurred in the 4th week or later.(3)In SPI group,81 strains of microorganisms were cultured,including 45 strains of gram-negative bacteria(55.6%),22 strains of gram-positive bacteria(27.2%),and 14 strains of fungi (17.3%).The common gram-negative bacteria were Escherichia coli,and the common gram-positive bacteria were Staphylococci and Enteroeocei.The fungi included Monilia and Yeastoid fungus. Further study revealed that 35 strains of all the microorganisms were intestinal bacteria(43.2%).Conclusions Continuous hvpoalbuminemia,prolonged time of central venous catheter and usage of hormone were independent risk factors of SPI.The main type of infection was pancreatic abscess.Gram-negative bacteria,were the common bacteria causing secondary pancreatic infection.