胰腺术后腹腔细菌感染病原菌特性及治疗.docVIP

胰腺术后腹腔细菌感染病原菌特性及治疗 　　[摘要] 目的 探讨胰腺术后腹腔细菌感染菌谱及耐药情况，并取抗生素行针对性治疗。方法 随机选取医院胰腺手术患者80例作为研究对象，取腹腔内引流液行细菌培养和药敏实验。 结果 该组80例患者中，31例出现腹腔细菌感染，占38.75%。分离出42株细菌，3株为革兰阳性菌，占7.14%；38株为革兰阴性菌，占91.48%，其中铜绿假单胞菌占50.0%。38例革兰阴性菌药实验结果显示，对庆大霉素、多占菌素B、阿米卡星的敏感性较高分别为70.27%、77.42%、78.95%，对头孢唑林、头孢吡肟、哌拉西林的敏感性较低，分别为0.0%、27.78%、28.57%。根据患者发热情况行腹腔引流或腹腔引流联合敏感抗生素治疗均痊愈出院。 结论 胰腺术后腹腔细菌感染病以革兰阴性菌为主，病原菌呈多重耐药性，临床可根据患者发热及药敏感实验结果，合理取抗生素用药，控制腹腔感染。 　　[关键词] 胰腺手术；腹腔感染；病原菌；耐药性 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）04（c）-0022-02 　　[Abstract] Objective To investigate the bacterial spectrum and drug resistance of bacteria with abdominal infection after pancreatic surgery， and to take antibiotics for targeted therapy. Methods Selected 80 patients with pancreatic surgery in our hospital as the research object， took drainage for bacterial culture and drug sensitive test in abdominal cavity. Results 80 patients in this group， 31 cases with abdominal cavity bacterial infection， accounted for 38.75%. 42 bacterial strains were isolated， 3 cases were gram positive bacteria， accounting for 7.14%； 38 strains were gram negative bacilli， accounting for 91.48%， among which of pseudomonas aeruginosa accounted for 50%. 38 cases of gram negative bacteria medicine experimental results showed higher sensitivity to gentamicin， accounted for by actinomycin B， Amikacin was respectively 70.27%， 77.42%， 78.95%， with lower sensitivity to cefazolin， cefepime， piperacillin， were respectively 0%， 27.78%， 28.57%. According to the situation of patients with fever for peritoneal drainage or peritoneal drainage combined with sensitive antibiotics were cured. Conclusion Pancreatic postoperative intraperitoneal bacterial infection with Gram negative bacteria were the main pathogens multiple drug resistance， clinical according to the patients with fever and drug sensitive test results， reasonable antibiotic drugs， and control the abdominal infection. 　　[Key words] Pancreatic operation； Abdominal infection； Pathogen； Drug resistance 　　因胰腺