肝癌术后腹腔感染的诊治.docxVIP

肝癌术后腹腔感染的诊治 【摘要】目的：探究肝癌术后腹腔感染的诊断和治疗。方法选取我院的30例2014年12 月~2016年3月收治的疑似肝癌术后发生腹腔感染患者，诊断方法为血液、引流液培养，并 对30例患者实施腹部CT检查；确诊患者采用穿刺引流、抗感染、多器官功能支持、调整免 疫抑制剂的种类和数量等多种方式的综合治疗，观察治疗效果。结果①诊断结果：30例患 者经过诊断均确诊为肝癌术后腹腔感染；②病原学检查结果：经引流液培养得阳性菌36株， 其中粪肠球菌15株占41. 67%、大肠埃希菌7株占19. 44%、肺炎克雷伯菌6株占16. 67%； 粪肠球菌对青霉素耐药率为85. 71%；③治疗结果:治愈患者有28例(93.33%),死亡患者 有2例(6. 67%).结论对于肝癌术后疑似腹腔感染的患者可以采用病原学检查和腹部CT 检查的方法进行诊断；对于确诊为肝癌术后腹腔感染的患者可以采用综合治疗的方法进行治 疗。 【关键词】 肝癌；腹腔感染；诊断；治疗 The Diagnosis and treatment of abdominal infection after operation of liver cancer[Abstract ] Objective: To investigate the abdominal infection after liver resection for hepatocellular carcinoma diagnosis and treatment. Methods in our hospital of 30 cases of December 2014 to 2016 year March were suspected hepatocellular carcinoma occurred in patients with abdominal infection, diagnosis method fbr blood, drainage fluid culture, and abdominal CT examination in 30 patients; accurate diagnosis were treated by puncture and drainage, anti infection, multiple organ function support, adjustment of immunosuppressive agents as the quantity and kinds of various ways of comprehensive treatment observed treatment effect. Results (1) the diagnosis results: 30 patients after diagnosis were diagnosed abdominal infection after liver resection for hepatocellular carcinoma; Il etiological examination results: the drainage fluid culture was positive Bacterial 36 strains. Among E. faecal is 15 strains (41.67%), Escherichia coli 7 strains accounted for 19.4%, Klebsiella pneumoniae 6 strains of 16.67%; Enterococcus faecalis penicillin resistant rate was 85.71%; (3) in the treatment of results: cure the patient of a 28 (93.33%), death patients in 2 cases (6.67%). Conclusion after hepatectomy for hepatocellular carcinoma (HCC) suspected patients with abdominal infection can by pathogen examination and abdominal CT diagnosis; for the diagnosis of abdominal infection after liver resection for hepatocellular carcinoma in patients with can were treated with comprehensive t