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1、重症急性胰腺炎并发肺部感染的临床分析消化外科2005年第4卷第6期399—401JournalofDigestiveSurgery,2005,4(6):399—401文章编号:1671—4555(2005)06—0399—03?399??临床研究?重症急性胰腺炎并发肺部感染的临床分析高金波熊炯昕吕平王春友【摘要】目的分析重症急性胰腺炎并发肺部感染的临床特点及危险因素,并探讨其防治措施.方法回顾性分析190例重症急性胰腺炎患者的l临床资料,研究肺部感染的发生率,感染菌的种类,比较感染和非感染组死亡率以及采用Logistic回归分析方法分析肺部感染的危险因
2、素.结果67例重症急性胰腺炎并发肺部感染,发生率为35.3,感染者死亡率为28.4,明显高于非感染组(PdO.05);感染菌以革兰阴性菌为主,占73.6,以铜绿假单胞菌,肺炎克雷伯菌和鲍曼不动杆菌为多见;21例存在两种或两种以上病原菌混合感染;APACHEII评分≥15,呼吸机治疗,气管切开,年龄≥6O岁和手术治疗是肺部感染的高危因素.结论重症急性胰腺炎患者并发肺部感染的发病率和死亡率较高.应针对其感染特点及危险因素,及时采取相应防治措施,改善其预后.【关键词】重症急性胰腺炎肺部感染【中图法分类号】R576.1【文献标识码】AClinicalstudy
3、ofpulmonaryinfectioninsevereacutepancreatitisGaoJinbo.XiongJiongxin.L"Ping,WangChunyou.DepartmentofGeneralSurgery,XieheHospital,HuazhongUniversityofScienceandTechnology,Wuhan430022,China[Abstract]ObjectiveToanalyzetheclinicalcharacteristicandriskfactorsofpulmonaryinfec—tioninpat
4、ientswithsevereacutepancreatitis,andinvestigatepreventionandtreatmentstrategy.MethodsTheclinicaldataof190caseswithsevereacutepancreatitiswereanalyzed,retrospectively.Thepulmonaryinfectionrateandpathogensspecieswerestudied.Logisticregressionanalyseswasusedforanlalysingtheriskfact
5、ors.ResultsPulmonaryinfectionwasfoundin67cases,andthein-fectionratewas35.3.Themortalityofthoseinfectedpatientswas28.4.whichwashigherthanthatoftheuninfected(Pd0.05).Gram-negativebacilliaccountedfor73.6ofthepathogens.andthemainpathogenswerePseudomonasaeruginosa,KlebsielIapneumonia
6、eandAcinetobacterbauman-nii.TheCO—infectinwithtwospeciesOfbacteriaorabovewasfoundin21cases.APACHElIscore≥15,mechanicalventilationtreatment,tracheotomy,ageover60andoperationtreatmentweretheriskfactorsofpulmonaryinfection.ConclusionsPulmonaryinfectioninsevereacutepancreatitispatie
7、ntswithpulmonaryinfectionhadhighmorbidityandmortality.AccordingtOthecharacterandriskfactorsofpulmonaryinfection,weshouldtakemeasurestOreducetherateofinfection.[Keywords]severeacutepancreatitispulmonaryinfection近年来随着对重症急性胰腺炎(severeacutepancreatitis,SAP)病理生理研究的深入和治疗措施的进步,早期脏器功能衰竭所
8、引起的死亡有所下降,但与感染有关的并发症已成为最主要的死亡原因.其中肺部感染是常见的并发症,且
