中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
9期
2080-2082
,共3页
胰腺感染%重症急性胰腺炎%危险因素%预防
胰腺感染%重癥急性胰腺炎%危險因素%預防
이선감염%중증급성이선염%위험인소%예방
Pancreatic infection%Severe acute pancreatitis%Risk factor%Prevention
目的：研究重症急性胰腺炎（SAP）继发胰腺感染的危险因素，为临床诊治提供参考。方法选取2012年6月－2013年12月医院收治的S A P患者102例为研究对象，根据是否继发胰腺感染将其分为感染组38例，未感染组64例；对胰腺感染的危险因素进行分析，采用SPSS17．0软件对数据进行统计分析。结果胰腺感染率为37．25％；感染组共培养出69株病原菌，其中革兰阴性菌占73．91％；革兰阳性菌占26．09％；革兰阴性杆菌对亚胺培南、美罗培南较敏感，敏感率为100．00％、92．11％；革兰阳性菌对万古霉素敏感，敏感率为100．00％；两组血钙（Ca2＋）浓度、APACHEⅡ评分、糖尿病、低氧血症、胰腺坏死分期、多器官功能障碍综合征（MODS）、胃肠功能障碍、机械通气时间、肠外营养时间比较差异有统计学意义（P＜0．05）；logistic回归分析显示，低血Ca2＋、合并糖尿病、MODS、Ⅲ期胰腺坏死、胃肠功能障碍≥7 d是SAP继发胰腺感染的独立危险因素。结论 SAP继发胰腺感染的危险因素复杂，对合并糖尿病、M ODS、胰腺坏死患者采取积极预防措施，降低胰腺感染风险。
目的：研究重癥急性胰腺炎（SAP）繼髮胰腺感染的危險因素，為臨床診治提供參攷。方法選取2012年6月－2013年12月醫院收治的S A P患者102例為研究對象，根據是否繼髮胰腺感染將其分為感染組38例，未感染組64例；對胰腺感染的危險因素進行分析，採用SPSS17．0軟件對數據進行統計分析。結果胰腺感染率為37．25％；感染組共培養齣69株病原菌，其中革蘭陰性菌佔73．91％；革蘭暘性菌佔26．09％；革蘭陰性桿菌對亞胺培南、美囉培南較敏感，敏感率為100．00％、92．11％；革蘭暘性菌對萬古黴素敏感，敏感率為100．00％；兩組血鈣（Ca2＋）濃度、APACHEⅡ評分、糖尿病、低氧血癥、胰腺壞死分期、多器官功能障礙綜閤徵（MODS）、胃腸功能障礙、機械通氣時間、腸外營養時間比較差異有統計學意義（P＜0．05）；logistic迴歸分析顯示，低血Ca2＋、閤併糖尿病、MODS、Ⅲ期胰腺壞死、胃腸功能障礙≥7 d是SAP繼髮胰腺感染的獨立危險因素。結論 SAP繼髮胰腺感染的危險因素複雜，對閤併糖尿病、M ODS、胰腺壞死患者採取積極預防措施，降低胰腺感染風險。
목적：연구중증급성이선염（SAP）계발이선감염적위험인소，위림상진치제공삼고。방법선취2012년6월－2013년12월의원수치적S A P환자102례위연구대상，근거시부계발이선감염장기분위감염조38례，미감염조64례；대이선감염적위험인소진행분석，채용SPSS17．0연건대수거진행통계분석。결과이선감염솔위37．25％；감염조공배양출69주병원균，기중혁란음성균점73．91％；혁란양성균점26．09％；혁란음성간균대아알배남、미라배남교민감，민감솔위100．00％、92．11％；혁란양성균대만고매소민감，민감솔위100．00％；량조혈개（Ca2＋）농도、APACHEⅡ평분、당뇨병、저양혈증、이선배사분기、다기관공능장애종합정（MODS）、위장공능장애、궤계통기시간、장외영양시간비교차이유통계학의의（P＜0．05）；logistic회귀분석현시，저혈Ca2＋、합병당뇨병、MODS、Ⅲ기이선배사、위장공능장애≥7 d시SAP계발이선감염적독립위험인소。결론 SAP계발이선감염적위험인소복잡，대합병당뇨병、M ODS、이선배사환자채취적겁예방조시，강저이선감염풍험。
OBJECTIVE To explore the risk factors for secondary pancreatic infections in the patients with severe a‐cute pancreatitis (SAP) so as to provide guidance for clinical diagnosis and treatment .METHODS A total of 102 patients with SAP who were treated from Jun 2012 to Dec 2013 were recruited as the study objects and divided into the infection group with 38 cases and the non‐infection group with 64 cases according to the status of secondary pancreatic infections .The risk factors for the pancreatic infections were analyzed ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The incidence of pancreatic infections was 37 .25% .To‐tally 69 strains of pathogens have been cultured from the infection group ,of which 73 .91% were the gram‐nega‐tive bacteria ,and 26 .09% were the gram‐positive bacteria .The gram‐negative bacilli were highly susceptible to imipenem and meropenem ,with the drug susceptibility rates of 100 .00% and 92 .11% ,respectively ;the gram‐positive bacteria were highly susceptible to vancomycin ,with the drug susceptibility rate of 100 .00% .There was significant difference in the concentration of blood calcium (Ca2+ ) ,APACHEⅡ score ,diabetic mellitus ,hyox‐emia ,pancreatic necrosis staging ,multiple organ dysfunction syndrome (MODS) ,gastrointestinal dysfunction , mechanical ventilation time ,or parenteral nutrition time between the two groups (P<0 .05) .The logistic regres‐sion analysis indicated that the low concentration of blood Ca2+ ,complication of diabetic mellitus ,M ODS ,pancre‐atic necrosis stage Ⅲ ,and gastrointestinal dysfunction no less than 7 days were the independent risk factors for the secondary pancreatic infections in the patients with SAP .CONCLUSION The risk factors for the secondary pancre‐atic infections in the patients with SAP are complex .As for the patients complicated with diabetic mellitus , MODS ,or pancreatic necrosis ,it is necessary to actively take the prevention measures so as to reduce the risk of pancreatic infections .
