本文選題：李斯特菌 + 妊娠��； 參考：《北京協(xié)和醫(yī)學(xué)院》2015年博士論文

【摘要】：[目的]：探討綜合醫(yī)院李斯特菌病的臨床特點、高危因素及治療轉(zhuǎn)歸,以揭示其發(fā)病特點,提高對李斯特菌病的認(rèn)識。[方法]：以計算機(jī)檢索系統(tǒng)結(jié)合人工檢索,對北京協(xié)和醫(yī)院1999年1月～2014年12月經(jīng)病原學(xué)檢查確診的李斯特菌病的臨床資料進(jìn)行回顧性分析,并結(jié)合文獻(xiàn)復(fù)習(xí),以闡述其臨床特點和轉(zhuǎn)歸。[結(jié)果]：1、在1999年1月～2014年12月共收治李斯特菌病病人69例,成人非妊娠相關(guān)性、妊娠期和新生兒李斯特菌病各占68.1%、23.2%和8.7%,病例數(shù)呈明顯增長趨勢。2、妊娠期病例年齡(30±3.9)歲,發(fā)生在妊娠早、中、晚期分別為1例、8例、7例；臨床表現(xiàn)為發(fā)熱(93.8%)、血白細(xì)胞增高(78.6%)、胎盤急性胎膜絨毛膜炎(77.8%)、胃腸道癥狀(37.5%)、胎動減少或消失(31.3%)等；15例出現(xiàn)不良妊娠結(jié)局,導(dǎo)致胎兒死亡8例、新生兒李斯特菌敗血癥經(jīng)治療存活7例；初始經(jīng)驗性抗微生物藥物李斯特菌覆蓋率低。3、6例新生兒均為播散性感染,除1例早產(chǎn)兒死亡外,5例存活。4、成人非妊娠期李斯特菌病47例,年齡平均(46.6±17.1)歲,男性18例(38.3%)；臨床表現(xiàn)為敗血癥(51.1%)、中樞神經(jīng)系統(tǒng)感染(25.5%)和敗血癥和中樞神經(jīng)系統(tǒng)感染(23.4%)；91.5%病人存在基礎(chǔ)病,以自身免疫病(46.8%)、惡性腫瘤(29.8%)多見；經(jīng)驗性抗生素有效覆蓋率為27.7%；死亡率36.2%。5、21例(44.7%)的成人非妊娠感染發(fā)生在因基礎(chǔ)疾病治療的住院病人中,涉及7個病房,在時間和空間上無聚集現(xiàn)象。[結(jié)論]：在北京一家綜合性醫(yī)院近16年收治的69例李斯特菌病主要累及存在基礎(chǔ)性自身免疫病、惡性腫瘤的病人及孕婦,尤其是因基礎(chǔ)疾病住院中的病人；以敗血癥、中樞神經(jīng)系統(tǒng)感染、不良妊娠結(jié)局為主要臨床表現(xiàn),經(jīng)驗性抗生素有效覆蓋率低,病死率高。因此,李斯特菌病的發(fā)病在我國可能被低估,需要提高警惕。
[Abstract]:Objective: to explore the clinical characteristics, high risk factors and therapeutic outcome of Listeria in general hospital, so as to reveal the characteristics of the disease and improve the understanding of Listeria. [methods]: the clinical data of Listeria from January 1999 to December 2014 in Beijing Union Hospital were retrospectively analyzed by computer retrieval system and artificial retrieval, and the literature was reviewed. In order to explain its clinical characteristics and outcome. [results] from January 1999 to December 2014, 69 patients with Listeria disease were admitted to the hospital. The incidence of non-pregnancy related adults was 68.2% and 8.7% respectively during pregnancy and neonatal Listeria. The number of cases showed an obvious increasing trend. The age of the cases during pregnancy was 30 鹵3.9 years old. In the early, middle and late trimester of pregnancy, there were 8 cases of early pregnancy, 7 cases of late pregnancy, 7 cases of early pregnancy, 7 cases of late pregnancy, 7 cases of fever 93.8%, 78.6% of leukocytosis, 77.8% of placental acute placental chorionitis, 37.5% of gastrointestinal symptoms, 31.3% of fetal motility decrease or disappearance of fetal movements), and 15 cases of adverse pregnancy outcome. There were 8 cases of fetal death, 7 cases of neonatal listeria septicemia and 6 cases of disseminated infection. In addition to one premature infant death, 5 cases survived, 47 cases of adult non-pregnancy Listeria complicating disease, the average age was 46.6 鹵17.1 years old. The clinical manifestations were septicemia (51.1%, central nervous system infection 25.5) and septicemia and central nervous system infection (23.41.5%). The effective coverage rate of empirical antibiotics was 27.7.The mortality rate was 36.2.50.21 cases of adult non-pregnancy infection occurred in the inpatients who were treated with basic diseases, involving 7 wards, and there was no aggregation in time and space. [conclusion]: 69 cases of listeria in a general hospital in Beijing in the last 16 years mainly involve patients with basic autoimmune disease, malignant tumor patients and pregnant women, especially those hospitalized because of basic diseases. Central nervous system infection, adverse pregnancy outcome is the main clinical manifestation, the effective coverage of empirical antibiotics is low, the death rate is high. Therefore, the incidence of Listeria may be underestimated in China, need to be vigilant.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R517.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 張風(fēng)雷;戴桂勛;湯洵;卓菲;卓麗;楊湘霞;張艷;;飲食業(yè)單核細(xì)胞增生性李斯特菌污染狀況分析[J];現(xiàn)代預(yù)防醫(yī)學(xué);2008年04期

2 吳蜀豫,李迎惠,冉陸,付萍,李志剛,姚景會;中國2001年11省(市)食品中李斯特菌污染狀況的主動監(jiān)測[J];中華流行病學(xué)雜志;2003年08期

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