【摘要】：目的探討肝硬化失代償患者腹水的病原學(xué)特點以及對抗菌藥物的敏感性,為臨床治療提供參考。方法選取2011年3月-2013年12月肝硬化失代償合并院內(nèi)不典型腹水自發(fā)性感染患者174例,采集患者腹水進(jìn)行病原菌培養(yǎng)以及藥物敏感試驗,采用SPSS13.0軟件對數(shù)據(jù)進(jìn)行統(tǒng)計分析。結(jié)果 174例患者共檢出病原菌182株,其中部分患者存在多重感染;檢出革蘭陰性菌94株占51.65%,革蘭陽性菌79株占43.41%,真菌9株占4.94%;革蘭陰性菌對呋喃妥因、阿米卡星以及頭孢西丁表現(xiàn)出了較高的敏感性,分別達(dá)到95.74%、94.68%和92.55%,而對氨芐西林/舒巴坦敏感性較低,僅為45.74%;革蘭陽性菌對萬古霉素均敏感,達(dá)到100.00%,而普遍對紅霉素敏感性較低,僅為58.23%。結(jié)論肝硬化失代償患者腹水自發(fā)性感染的病原菌分布較廣,部分患者可同時存在多種病原菌感染,應(yīng)根據(jù)經(jīng)驗及時給予抗菌藥物聯(lián)合應(yīng)用,待結(jié)果報告后及時對藥物進(jìn)行調(diào)整,以期控制、改善患者預(yù)后。
[Abstract]:Objective to investigate the etiological characteristics and antimicrobial sensitivity of ascites in patients with decompensated cirrhosis. Methods from March 2011 to December 2013, 174 patients with decompensated cirrhosis complicated with spontaneous infection of atypical ascites were collected for pathogen culture and drug sensitivity test. The data were statistically analyzed by SPSS13.0 software. Results 182 strains of pathogens were detected in 174 patients, some of them had multiple infections, 94 strains of Gram-negative bacteria accounted for 51.65%, 79 strains of Gram-positive bacteria accounted for 43.41%, 9 strains of fungi accounted for 4.94%. Gram-negative bacteria showed high sensitivity to furantoin, amikacin and cefoxitin, reaching 95.74% and 92.55%, respectively, while ampicillin / sulbactam was less sensitive to ampicillin / sulbactam (45.74%). Gram-positive bacteria were sensitive to vancomycin, reaching 100.00m, but generally less sensitive to erythromycin (58.23cm). Conclusion the pathogenic bacteria of ascites spontaneous infection in patients with decompensated liver cirrhosis are widely distributed, and some patients may have multiple pathogens at the same time. The combined use of antimicrobial agents should be given in time according to experience, and the drugs should be adjusted in time after the results are reported. In order to control and improve the prognosis of patients.
【作者單位】： 平頂山市第一人民醫(yī)院消化內(nèi)科;
【基金】：河南省衛(wèi)生廳重點扶持基金資助項目(HW-2012B-037)
【分類號】：R575.2

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