本文選題：重癥急性胰腺炎 + 繼發(fā)胰腺感染�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年05期

【摘要】：目的分析重癥急性胰腺炎(SAP)繼發(fā)胰腺感染的危險(xiǎn)因素和感染特點(diǎn)。方法重癥急性胰腺炎患者80例,進(jìn)行腹腔穿刺及細(xì)菌培養(yǎng),在對(duì)重癥急性胰腺炎是否繼發(fā)胰腺感染的相關(guān)情況進(jìn)行單因素分析的基礎(chǔ)上,探討重癥急性胰腺炎繼發(fā)胰腺感染的危險(xiǎn)因素,并分析感染特點(diǎn)。結(jié)果共25例繼發(fā)胰腺感染,感染率為31.25%;患者中機(jī)械通氣時(shí)間≥6h、禁食時(shí)間≥15d、胃腸功能障礙時(shí)間≥2d、中心靜脈留置導(dǎo)管時(shí)間≥6d、有心血管并發(fā)癥、胰腺外部感染、全身炎癥反應(yīng)綜合征、低氧血癥、有多器官功能衰竭及入院WBC計(jì)數(shù)≥20×109/L的,繼發(fā)胰腺炎感染率顯著增高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);重癥急性胰腺炎繼發(fā)胰腺感染的獨(dú)立危險(xiǎn)因素為胃腸功能障礙、低氧血癥、中心靜脈留置導(dǎo)管時(shí)間較長(zhǎng)、禁食時(shí)間較長(zhǎng)及入院WBC計(jì)數(shù)、C-反應(yīng)蛋白較高;25例感染患者分離出30株菌株,陰溝腸桿菌12株占40.00%、銅綠假單胞菌8株占26.67%、大腸埃希菌5株占16.67%、金黃色葡萄球菌4株占13.33%、肺炎克雷伯菌1株占3.33%。結(jié)論重癥急性胰腺炎繼發(fā)胰腺感染的獨(dú)立危險(xiǎn)因素為胃腸功能障礙、低氧血癥、中心靜脈留置導(dǎo)管時(shí)間較長(zhǎng)、禁食時(shí)間較長(zhǎng)及入院WBC計(jì)數(shù)較高,根據(jù)患者實(shí)際情況給予針對(duì)性治療,選擇適當(dāng)?shù)目咕幬?有利于預(yù)防或減少胰腺感染,改善預(yù)后。
[Abstract]:Objective to analyze the risk factors and characteristics of pancreatic infection secondary to severe acute pancreatitis (SAP). Methods Peritoneal puncture and bacterial culture were performed in 80 patients with severe acute pancreatitis. To investigate the risk factors of pancreatic infection secondary to severe acute pancreatitis and analyze the characteristics of infection. Results there were 25 cases of secondary pancreatic infection, the infection rate was 31.25.The duration of mechanical ventilation 鈮，

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