CAJ | 학술논문

目的：探讨儿童胃肠外科感染性疾病的特点及抗菌药物治疗原则。方法对该院胃肠外科2010～2012年住院感染性疾病患儿2625例（发病率占总住院人数的27．52％，其中耐药菌感染率为15．70％）的发病率、病种、致病菌、并发症、抗菌药物使用情况等进行回顾性分析。结果2625例中感染性疾病患儿中，感染性疾病中前5位分别为阑尾炎（40．72％）、肛周脓肿（21．53％）、阑尾周围脓肿（9．30％）、坏死性小肠结肠炎（3．73％）、脐炎（2．93％）。前3位致病菌分别为大肠埃希菌、肺炎克雷伯菌亚种、金黄色葡萄球菌。浅表耐药菌感染有255例，深部耐药菌感染有157例，使用1、2代头孢或半合成青霉素49例，使用3、4代头孢或β内酰胺／β内酰胺酶抑制剂346例，使用碳氢霉烯类抗菌药物或万古霉素17例。本组无死亡或广谱耐药菌医院感染患儿。结论84．3％小儿外科感染患儿仍对常用抗菌药物敏感，机会菌感染是其主要特点。儿童重症感染应根据临床特点及药敏试验合理使用抗菌药物，浅表耐药菌感染或深部耐药菌感染患儿使用限制性抗菌药物；深部耐药菌感染患儿使用特殊级抗菌药物。
목적：탐토인동위장외과감염성질병적특점급항균약물치료원칙。방법대해원위장외과2010～2012년주원감염성질병환인2625례（발병솔점총주원인수적27．52％，기중내약균감염솔위15．70％）적발병솔、병충、치병균、병발증、항균약물사용정황등진행회고성분석。결과2625례중감염성질병환인중，감염성질병중전5위분별위란미염（40．72％）、항주농종（21．53％）、란미주위농종（9．30％）、배사성소장결장염（3．73％）、제염（2．93％）。전3위치병균분별위대장애희균、폐염극뢰백균아충、금황색포도구균。천표내약균감염유255례，심부내약균감염유157례，사용1、2대두포혹반합성청매소49례，사용3、4대두포혹β내선알／β내선알매억제제346례，사용탄경매희류항균약물혹만고매소17례。본조무사망혹엄보내약균의원감염환인。결론84．3％소인외과감염환인잉대상용항균약물민감，궤회균감염시기주요특점。인동중증감염응근거림상특점급약민시험합리사용항균약물，천표내약균감염혹심부내약균감염환인사용한제성항균약물；심부내약균감염환인사용특수급항균약물。
Objective To analyze the pattern of antibiotic use and antibiotic resistance tendency of gastrointestinal surgery in a tertiary children′s hospital .Methods 2 625 patients(which account for 27 .52% of all the hospilitalized patients ,the resistant rate was 15 .70% ) detailed morbidity ,entity ,bacteria ,complication ,antibiotic utilization was retrospectively reviewed using the hospital medical records from 2010 to 2012 .Results 2 625 patients the percentages of the top five disease category were :appendicitis ac-counting for 40 .72% ,perianal abscess accounting for 21 .53% ,periappendiceal abscess accounting for 9 .30% ,necrotizing enterocol-itis accounting for 3 .73% ,omphalitis accounting for 2 .93% .The top three pathogen were :escherichia coli ,klebsiella pneumoniae subsp ,staphylococcus aureus respectively .255 multi-resistant bacteria of the superficial infection patients and 157 of the invasive in-fection patients .49 multi-resistant infections were cured by first or second generation of cephalosporins and penicillinase-fast peni-cillin ,and 346 were cured by third or forth generation of cephalosporins and penicillinase-fast penicillin ,and 17 were cured by car-bapenem or vancomycin .No dead or multi-resistant hospital infectious case was reviewed .Conclusion The sensitive rates of surgi-cal infected patient were 84 .3% ,and opportunistic pathogen infection was the main characteristics .To aware the clinical character-istics and drug sensitive test is conductive to the reasonable use of antibiotics of severe infections .The cases of superficial resistant infection or invasive non-resistant infection tend to use restricted antibiotics .The cases of invasive resistant infection tend to use special antibiotics .