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目的探讨原发性肝内胆管结石与胆道感染的关系。方法手术过程中,在无菌条件下收集35例原发性肝内胆管结石病人的胆管胆汁35份,结石30份,进行需氧菌培养,并对部分结石行扫描电镜和透射电镜观察。结果胆汁细菌培养阳性率为94.2％,结石细菌培养阳性率为96.7％。胆汁和胆石培养出的细菌种类相似,均以肠球菌属细菌占首位,其次为大肠杆菌和克雷伯菌属。对6例肝内胆管结石行扫描电镜观察,5例行透射电镜观察,均观察到结石内有细菌存在,这11例病人的胆汁、胆石细菌培养均呈阳性。结论原发性肝内胆管结石内有细菌存在,可能是引起胆道感染的重要感染源之一。
Objective To investigate the relationship between primary intrahepatic bile duct stones and biliary tract infection. Methods During the operation, 35 cases of bile duct stones and 35 cases of primary intrahepatic bile duct stones under aseptic conditions were collected for aerobic bacterial culture. Scanning electron microscopy and transmission electron microscopy were performed on some of the stones. Results The positive rate of bile bacteria culture was 94.2% and the positive rate of bacterial culture of stones was 96.7%. Bile and gallstone bacteria are similar to the type of bacteria, enterococcus bacteria are the top, followed by Escherichia coli and Klebsiella. Six cases of intrahepatic bile duct stones were observed by scanning electron microscopy and five cases were observed by transmission electron microscopy. Bacteria were found in the stones. The bile and gallstone bacteria cultures of the 11 cases were all positive. Conclusion The presence of bacteria in the primary intrahepatic bile duct stones may be one of the important sources of biliary tract infection.