论文部分内容阅读
目的分析重症急性胰腺炎(SAP)患者感染的易感因素及感染类型,指导临床正确预防及合理治疗。方法回顾性调查医院2004年2月-2013年2月收治的SAP患者的临床资料;通过56例SAP合并感染组患者与185例非感染组患者的对比与分析,探究急性胰腺炎合并感染的易感因素;通过对56例合并感染患者的病原菌检测,分析患者合并感染的感染类型。结果在241例SAP患者中死亡39例,病死率为16.18%;其中感染组56例患者中死亡22例,病死率为39.29%;非感染组185例患者死亡17例,病死率为9.19%;感染组者与非感染组患者的治疗时间、APACHEⅡ评分、CT评分、氧分压、肠功能恢复时间等指标差异有统计学意义(P<0.05),是SAP合并感染的易感因素;56例SAP合并感染患者中,40例确诊有细菌感染,细菌感染率为71.43%。54例有真菌感染,真菌感染率为96.43%;其中38例为细菌与真菌混合感染。结论急性重症胰腺炎合并感染患者病死率高,通过对其易感因素及感染类型的分析,积极做好预防措施以及临床合理治疗,对提高重症胰腺炎合并感染患者的生存率有重要意义。
Objective To analyze the predisposing factors and types of infection in patients with severe acute pancreatitis (SAP) and to guide clinical proper prevention and rational treatment. Methods The clinical data of patients with SAP admitted in our hospital from February 2004 to February 2013 were retrospectively reviewed. The comparison and analysis of 56 SAP patients with SAP and 185 non-infected patients were carried out to explore the relationship between SAP infection and acute pancreatitis Through analyzing the pathogenic bacteria in 56 cases of co-infected patients, the type of infection in patients with co-infection was analyzed. Results Of the 241 SAP patients, 39 died and the case fatality rate was 16.18%. Among 56 patients in the infection group, 22 were dead and the case fatality rate was 39.29%. In the non-infected group, 185 patients died and the case fatality rate was 9.19% The treatment time, APACHEⅡscore, CT score, oxygen partial pressure and recovery time of intestinal function in patients with and without infection were significantly different (P <0.05), which were the predisposing factors for SAP infection. Among SAP patients with SAP infection, 40 cases were diagnosed as having bacterial infection, with a bacterial infection rate of 71.43%. 54 cases of fungal infection, the fungal infection rate was 96.43%; 38 cases of bacterial and fungal mixed infection. Conclusion The mortality of patients with acute severe pancreatitis complicated with infection is high. Through analyzing the predisposing factors and types of infection, preventive measures and clinical reasonable treatment are important to improve the survival rate of patients with severe pancreatitis complicated with infection.