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目的探讨急性胰腺炎患者腹腔感染的危险因素和病原学特征,为临床防治腹腔感染提供依据。方法回顾性分析医院2011年1月-2016年6月收治急性胰腺炎患者187例,分析不同临床特征的急性胰腺炎患者腹腔感染风险及危险因素和主要病原菌。结果不同病因的急性胰腺炎患者腹腔感染风险不同(P<0.05);入院时SOFA评分≥2分、APACHEⅡ评分≥8分、Ranson评分≥3分、CTSI评分≥4分、脏器功能损伤和休克的急性胰腺炎患者腹腔感染率显著升高(P<0.05);多因素回归分析显示,Ranson评分≥3分、CTSI评分≥4分、休克和脏器功能损伤是急性胰腺炎患者腹腔感染的危险因素(P<0.05);18例腹腔感染的患者共培养出病原菌32株,其中革兰阴性菌18株占56.25%,革兰阳性菌14株占43.75%,最常见的革兰阴性菌是铜绿假单胞菌,最常见的革兰阳性菌是金黄色葡萄球菌。结论 Ranson评分≥3分、CTSI评分≥4分、休克和脏器功能损伤是急性胰腺炎患者腹腔感染的危险因素,感染以革兰阴性菌为主。
Objective To investigate the risk factors and etiological characteristics of abdominal infection in patients with acute pancreatitis and provide basis for clinical prevention and treatment of abdominal infection. Methods A retrospective analysis of 187 hospitalized patients with acute pancreatitis from January 2011 to June 2016 was conducted to analyze the risk of abdominal infection and risk factors and major pathogenic bacteria in patients with acute pancreatitis with different clinical features. Results The risk of peritoneal infection was different in patients with acute pancreatitis with different etiology (P <0.05). SOFA score ≥2 points, APACHEⅡ score ≥8 points, Ranson score ≥3 points, CTSI score ≥4 points, organ function impairment and shock (P <0.05). Multivariate regression analysis showed that Ranson score ≥3, CTSI score ≥4, and shock and organ dysfunction were the risk of peritoneal infection in patients with acute pancreatitis (P <0.05). Among the 18 patients with intraperitoneal infection, 32 strains of pathogens were co-cultivated, of which, 18 strains of Gram-negative bacteria accounted for 56.25% and 14 strains of Gram-positive bacteria accounted for 43.75%. The most common gram-negative bacteria were patina Pseudomonas, the most common gram-positive bacteria is Staphylococcus aureus. Conclusion Ranson score ≥3, CTSI score ≥4, shock and organ dysfunction are risk factors of abdominal infection in patients with acute pancreatitis. Gram-negative bacteria are the main infection.