發(fā)布時(shí)間：2018-04-25 04:04

  本文選題：膿毒癥 + 微生物培養(yǎng)��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:了解重癥監(jiān)護(hù)病房膿毒癥患者微生物培養(yǎng)分離出的致病菌特點(diǎn)及探討影響微生物培養(yǎng)結(jié)果的相關(guān)因素。方法:采用回顧性分析方法,對(duì)2012年6月-2016年12月廣西醫(yī)科大學(xué)第一附屬醫(yī)院重癥監(jiān)護(hù)病房188例膿毒癥患者的一般情況、臨床和入住重癥病房24小時(shí)內(nèi)實(shí)驗(yàn)室檢查結(jié)果等資料的收集,了解本院重癥監(jiān)護(hù)病房膿毒癥患者微生物培養(yǎng)特點(diǎn),通過(guò)對(duì)微生物培養(yǎng)陽(yáng)性患者和陰性患者的一般情況、炎癥指標(biāo)、危重評(píng)分、預(yù)后及抗生素使用情況進(jìn)行分析,探討影響膿毒癥患者微生物培養(yǎng)結(jié)果的相關(guān)因素。結(jié)果:(1)微生物培養(yǎng)分離出病原菌112株,G-細(xì)菌48株(42.8%);真菌39株(34.8%);其中G+細(xì)菌13株(11.6%);混合感染12株(10.7%)。血培養(yǎng)分離出致病菌28株,陽(yáng)性率14.9%。(2)年齡、白細(xì)胞、中性粒細(xì)胞比值在微生物培養(yǎng)陽(yáng)性與陰性患者組間無(wú)統(tǒng)計(jì)學(xué)差異,微生物培養(yǎng)結(jié)果與PCT濃度、APACHE Ⅱ評(píng)分、SOFA評(píng)分、預(yù)后相關(guān),均成正相關(guān),微生物培養(yǎng)陽(yáng)性組患者在PCT濃度、APACHE Ⅱ評(píng)分、SOFA評(píng)分、病死率均比陰性組高。(3)PCT濃度對(duì)微生物培養(yǎng)結(jié)果影響有統(tǒng)計(jì)學(xué)意義,PCT參照水準(zhǔn)為PCT≥10ng/ml時(shí),在PCT0.5ng/ml微生物培養(yǎng)結(jié)果出現(xiàn)陰性的可能性是PCT≥10.0ng/ml的4.844倍。(4)PCT濃度、APACHE Ⅱ評(píng)分、SOFA評(píng)分預(yù)測(cè)微生物培養(yǎng)結(jié)果(陰性或陽(yáng)性)的ROC曲線下面積分別為0.628、0.632、0.618。結(jié)論:(1)本研究中重癥監(jiān)護(hù)病房膿毒癥患者微生物培養(yǎng)的致病菌最主要的是G-細(xì)菌,其次為真菌,然后是混合感染和G+細(xì)菌。(2)微生物培養(yǎng)結(jié)果與病情危重程度、PCT濃度呈正相關(guān),膿毒癥患者病情越重、PCT濃度越高,微生物培養(yǎng)陽(yáng)性率越高。
[Abstract]:Objective: to investigate the characteristics of pathogenic bacteria isolated from sepsis patients in intensive care unit (ICU) and the related factors affecting the results of microbial culture. Methods: the general situation of 188 sepsis patients in intensive care unit of the first affiliated Hospital of Guangxi Medical University from June 2012 to December 2016 was analyzed retrospectively. To collect the results of clinical and laboratory examination in intensive care unit within 24 hours, to understand the characteristics of microbial culture in sepsis patients in intensive care unit, and to investigate the general situation of positive and negative patients with microorganism culture. The inflammatory index, critical score, prognosis and antibiotic use were analyzed to explore the related factors affecting microbial culture results in sepsis patients. Results 112 strains of pathogenic bacteria were isolated from microorganism culture, 48 strains of G- bacteria were isolated, 39 strains of fungi were found to be 34. 8%, 13 strains of G bacteria were found to be 11. 6% and 12 strains of mixed infection were 10. 7% and 10. 7% respectively. 28 strains of pathogenic bacteria were isolated from blood culture, the positive rate was 14.9%. The age, the ratio of leukocytes and neutrophils were not significantly different between the positive and negative groups. The results of microbial culture were correlated with the PCT concentration and Apache 鈪，

本文編號(hào)：1799657