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Impact of secondary pancreatic infection on the prognosis of patients with severe acute pancreatitis:an analysis of 60 cases
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1003-0603.2004.01.002
- Key Word:
- 胰腺感染,继发性;胰腺炎,急性;预后
Abstract： 目的观察继发性胰腺感染(SPI)对重症急性胰腺炎(SAP)患者预后的影响.方法回顾性研究1980年1月1日-1999年12月31日收治的60例SAP患者的临床资料,分析与SPI发生相关的情况.结果 60例SAP患者发生SPI 29例,未发生SPI(NSPI)31例(48.3%比51.7%),两组患者在性别、平均年龄、Ranson分值、中华医学会(CMA)高危因素分值等方面没有明显差异,但SPI患者的平均住院时间、住院费用、急性生理与慢性健康状况评价体系Ⅱ(APACHEⅡ)分值、发热天数、院外滞留时间、白细胞升高持续天数、发病到排便的时间、手术次数等均明显高于NSPI患者.其中SPI患者死亡7例,NSPI患者死亡1例(病死率24.14%比3.23%).病原菌调查发现,SPI组单一感染14例(占48.3%),混合感染15例(占51.7%);病原菌种类:肠杆菌科27例(埃希氏菌属25例,克雷伯氏菌属1例,摩根氏菌属1例),假单胞菌属8例(铜绿假单胞菌7例,施氏假单胞菌1例),霉菌2例,其它类型细菌5例(枯草芽孢杆菌2例,革兰厌氧球菌1例,醋酸钙不动杆菌1例,表皮葡萄球菌1例),仅有2例血培养发现大肠杆菌.结论 SPI的实质是肠源性感染,且严重影响了SAP患者的预后,现有的治疗措施难以有效阻止肠源性感染的发生,需要寻找新型防治策略以弥补不足.
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