CAJ | 학술논문

目的分析不同程度急性胆管炎患者术中胆汁细菌培养的阳性率和细菌谱差异.方法回顾分析自2008年1月至2011年10月期间该院急性胆管炎患者241例,根据日本东京指南标准将患者分为不同等级,全部患者均经手术治疗,术中常规取胆汁送细菌培养,记录胆汁培养结果,数据经SPSS 16.0软件分析统计分析.结果该组细菌培养阳性率75.1％,共培养出细菌244株,其中革兰氏阳性菌139株,阴性菌99株,酵母菌6株.前五位细菌分别是大肠埃希菌、粪肠球菌、铅黄肠球菌、铜绿假单胞菌、肺炎克雷伯菌.轻度与重度胆管炎的感染阳性率差异有统计学意义(P＜0.05),但轻度与中度(P=0.141)、中度与重度(P=0.647)急性胆管炎阳性率差异无统计学意义.革兰氏阴性菌在中、重度胆管炎患者分布较革兰氏阳性菌普遍(P＜0.05).在中、重度急性胆管炎中,多重细菌感染比例较高(P＜0.05).结论胆道感染细菌仍以大肠杆菌及肠球菌为主,重型急性胆管炎较轻型急性胆管炎细菌培养阳性率高.革兰氏阴性菌在中、重度患者中的分布较阳性菌广,重型急性胆管炎中多重细菌感染较普遍.
목적 분석불동정도급성담관염환자술중담즙세균배양적양성솔화세균보차이.방법 회고분석자2008년1월지2011년10월기간해원급성담관염환자241례,근거일본동경지남표준장환자분위불동등급,전부환자균경수술치료,술중상규취담즙송세균배양,기록담즙배양결과,수거경SPSS 16.0연건분석통계분석.결과 해조세균배양양성솔75.1％,공배양출세균244주,기중혁란씨양성균139주,음성균99주,효모균6주.전오위세균분별시대장애희균、분장구균、연황장구균、동록가단포균、폐염극뢰백균.경도여중도담관염적감염양성솔차이유통계학의의(P＜0.05),단경도여중도(P=0.141)、중도여중도(P=0.647)급성담관염양성솔차이무통계학의의.혁란씨음성균재중、중도담관염환자분포교혁란씨양성균보편(P＜0.05).재중、중도급성담관염중,다중세균감염비례교고(P＜0.05).결론 담도감염세균잉이대장간균급장구균위주,중형급성담관염교경형급성담관염세균배양양성솔고.혁란씨음성균재중、중도환자중적분포교양성균엄,중형급성담관염중다중세균감염교보편.
Objective To analysis the different types of bacteria in patients with a varying severity of acute cholangitis.Methods 241 patients who presented with actue cholangitis between Jan 2008 to Oct 2011 to our hospital were retrospectively studied.These patients were divided into three groups according to the Tokyo Guideline.The bile specimens were obtained intraoperatively.The parameters were compared by SPSS 16.0 package program for statistical analysis.Results 75.1 percent of the patients were positive for bacteria in the bile.There were 241 strains of bacterium which included 139 Gram-positive bacteria,99 Gram-negative bacteria and 6 strains of microzyme.Escherichia coli,Enterococcus faecalis,Enterococcus casseliflavus,Pseudomonas aeruginosa and Klebsiella species were the most frequently isolated bacteria.The positive rates for bacteria were significantly different between patients with mild and severe cholangitis (P＜0.05).There was no significant difference between patients with moderate and mild cholangits (P=0.141),or moderate and severe cholangitis (P=0.647).Gram-negative bacteria were more common than Gram- positive bacteria in patients with moderate and severe acute cholangitis (P＜0.05).In patients with moderate and severe acute cholangitis,there was more patients with multiple and mixed bacterial infection.Conclusions Escherichia coli and Enterococcus species were more common in patients with acute cholangitis.The positive rate of bacteria in the bile in severe acute cholangitis was higher than that in mild acute cholangitis.In patients with moderate and severe cholangitis,Gram-negative bacterial infections and multiple and mixed bacterial infections were more common.