【摘要】：目的了解肝膽系統(tǒng)疾病患者膽汁分離病原菌情況及臨床特征。方法采用回顧性研究方法,收集和分析某院肝膽疾病患者膽汁標(biāo)本細(xì)菌培養(yǎng)結(jié)果及相關(guān)臨床資料。結(jié)果共收集肝膽系統(tǒng)疾病患者膽汁標(biāo)本406份,培養(yǎng)陽性率為64.53%,262份陽性標(biāo)本中分離單一病原菌的占62.21%(163份),2種病原菌的占32.83%(86份),3種病原菌的占4.96%(13份)。分離病原菌374株,其中革蘭陰性菌242株(64.71%),革蘭陽性菌131株(35.02%),真菌1株(0.27%)。肝硬化、既往有肝膽手術(shù)史、患膽道結(jié)石者膽汁分離病原菌陽性率均高于對照組(均P0.05),膽道系統(tǒng)不同部位結(jié)石患者的膽汁病原菌分離陽性率有差異;而不同年齡、性別、以及是否患肝膽腫瘤各組比較,差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。膽道系統(tǒng)有無結(jié)石、既往有無手術(shù)史患者膽汁分離病原菌種類構(gòu)成比較,差異無統(tǒng)計(jì)學(xué)意義(均P0.05);而肝硬化患者與無肝硬化患者膽汁分離病原菌種類構(gòu)成比較,差異有統(tǒng)計(jì)學(xué)意義(χ~2=14.058,P=0.001)。結(jié)論肝膽系統(tǒng)疾病患者膽汁分離菌以腸桿菌科細(xì)菌及腸球菌屬細(xì)菌單一感染為主,肝膽系統(tǒng)結(jié)石患者、既往肝膽手術(shù)患者及肝硬化患者膽汁分離病原菌陽性率較高。
[Abstract]:Objective to investigate the pathogenic bacteria isolated from bile of patients with hepatobiliary diseases and its clinical characteristics. Methods the bacterial culture results and clinical data of bile samples from patients with hepatobiliary diseases in a hospital were collected and analyzed retrospectively. Results 406 bile samples from patients with hepatobiliary diseases were collected. The positive rate of culture was 64.53%. Among 262 positive samples, 62.21% (163 samples) were isolated from single pathogen and 32.83% (86 cases) were isolated from two kinds of pathogens. The three pathogens accounted for 4.96% (13 cases). 374 strains of pathogenic bacteria were isolated, of which 242 (64.71%) were Gram-negative, 131 (35.02%) Gram-positive and 1 (0.27%) fungal. The positive rate of pathogenic bacteria in bile separation in patients with hepatolithiasis and hepatolithiasis was higher than that in control group (P 0.05). The positive rate of bile pathogen isolation in patients with choledocholithiasis in different parts of the biliary system was significantly higher than that in the control group (P 0.05). There was no significant difference in age, sex and hepatobiliary tumor (P0.05). There was no significant difference in the composition of pathogenic bacteria in bile separation between patients with or without cholelithiasis and patients with or without surgical history (P 0.05). There was a significant difference in the types of pathogens isolated from bile between patients with cirrhosis and those without cirrhosis (蠂 ~ 2 / 14.058, P < 0.001). Conclusion the isolated bacteria in bile of patients with hepatobiliary diseases are mainly Enterobacteriaceae bacteria and Enterococcus single infection. The positive rate of bacteria isolated from bile of patients with hepatobiliary stone, patients undergoing hepatobiliary surgery and patients with liver cirrhosis is higher than that of patients with hepatobiliary diseases.
【作者單位】： 湖南省人民醫(yī)院湖南師范大學(xué)附屬第一醫(yī)院;
【基金】：2016年度湖南省衛(wèi)生計(jì)生委科研計(jì)劃項(xiàng)目(C2016009) 湖南省人民醫(yī)院仁術(shù)基金(2016)
【分類號】：R575

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