重癥急性胰腺炎患者繼發(fā)胰腺感染的危險(xiǎn)因素研究
發(fā)布時(shí)間:2018-05-03 21:13
本文選題:胰腺感染 + 重癥急性胰腺炎 ; 參考:《中華醫(yī)院感染學(xué)雜志》2015年09期
【摘要】:目的研究重癥急性胰腺炎(SAP)繼發(fā)胰腺感染的危險(xiǎn)因素,為臨床診治提供參考。方法選取2012年6月-2013年12月醫(yī)院收治的SAP患者102例為研究對(duì)象,根據(jù)是否繼發(fā)胰腺感染將其分為感染組38例,未感染組64例;對(duì)胰腺感染的危險(xiǎn)因素進(jìn)行分析,采用SPSS17.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果胰腺感染率為37.25%;感染組共培養(yǎng)出69株病原菌,其中革蘭陰性菌占73.91%;革蘭陽(yáng)性菌占26.09%;革蘭陰性桿菌對(duì)亞胺培南、美羅培南較敏感,敏感率為100.00%、92.11%;革蘭陽(yáng)性菌對(duì)萬(wàn)古霉素敏感,敏感率為100.00%;兩組血鈣(Ca2+)濃度、APACHEⅡ評(píng)分、糖尿病、低氧血癥、胰腺壞死分期、多器官功能障礙綜合征(MODS)、胃腸功能障礙、機(jī)械通氣時(shí)間、腸外營(yíng)養(yǎng)時(shí)間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);logistic回歸分析顯示,低血Ca2+、合并糖尿病、MODS、Ⅲ期胰腺壞死、胃腸功能障礙≥7d是SAP繼發(fā)胰腺感染的獨(dú)立危險(xiǎn)因素。結(jié)論 SAP繼發(fā)胰腺感染的危險(xiǎn)因素復(fù)雜,對(duì)合并糖尿病、MODS、胰腺壞死患者采取積極預(yù)防措施,降低胰腺感染風(fēng)險(xiǎn)。
[Abstract]:Objective to study the risk factors of pancreatic infection secondary to severe acute pancreatitis (SAP) and to provide reference for clinical diagnosis and treatment. Methods 102 patients with SAP admitted in hospital from June 2012 to December 2013 were divided into infection group (n = 38) and uninfected group (n = 64) according to whether they had secondary pancreatic infection, and the risk factors of pancreatic infection were analyzed. The data were analyzed by SPSS17.0 software. Results the infection rate of pancreas was 37.25. 69 pathogenic bacteria were cultured in the infection group, of which 73.91 were Gram-negative bacteria, 26.09 were Gram-positive bacteria. Gram-negative bacilli were sensitive to imipenem and meropenem with a sensitivity rate of 100.00g / 92.110.Gram-positive bacteria were sensitive to vancomycin. The sensitivity rate was 100.00. the serum calcium concentration in the two groups was evaluated by Apache 鈪,
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