论文部分内容阅读
目的 研究危重肝炎患者气单胞菌败血症发生特点及其防治。方法 对1993年1月～2001年7月住院41例危重晚期肝硬化、重型肝炎,医院感染气单胞菌败血症41例,进行回顾性分析。结果41例患者培养气单胞菌48株（血液41株,腹水5株,胸水1株,咽拭子1株）;嗜水气单胞菌24株,温和气单胞菌21株,豚鼠气单胞菌3株;发病季节主要在每年的5～7月,发病率占总发病的61.5％。2000年1月～2001年7月发生的气单胞菌败血症是1993年1月～1999年7月的4.5倍,x2值为15.9,P值<0.001;感染休克占30.2％,死亡率19.5％;气单胞菌对多种抗生素敏感,氟喹诺酮类如环丙沙星、氧氟沙星、左氧氟沙星;头孢菌素类如头孢他啶、头孢哌酮、头孢噻肟100％敏感,仅头孢曲松敏感率97.1％。结论 气单胞菌败血症是危重肝炎患者死亡的重要原因;氟喹诺酮、头孢菌素类是目前治疗气单胞菌感染的首选抗生素,及早抗生素治疗,及时补充血容量和纠正脱水酸中毒是救治成功的关键。
Objective To study the characteristics and prevention and treatment of Aeromonas sepsis in patients with severe hepatitis. Methods From January 1993 to July 2001, 41 cases of critically ill patients with end stage cirrhosis, severe hepatitis and 41 cases of hospital infection with Aeromonas sepsis were retrospectively analyzed. Results 41 patients were cultured with 48 strains of Aeromonas (blood 41, ascites 5, pleural effusion 1, throat swab 1), Aeromonas hydrophila 24, Aeromonas sobria 21 and guinea pig gas 3 strains of monocytogenes; the incidence season mainly in May to July each year, the incidence of 61.5% of the total incidence. Aeromonas sp. Sepsis occurred from January 2000 to July 2001 was 4.5-fold from January 1993 to July 1999. The value of x2 was 15.9 and the value of P was less than 0.001. The infection sepsis accounted for 30.2% and the mortality rate was 19.5% ; Aeromonas sensitive to a variety of antibiotics, fluoroquinolones such as ciprofloxacin, ofloxacin, levofloxacin; cephalosporins such as ceftazidime, cefoperazone, cefotaxime 100% sensitive, only ceftriaxone sensitive Rate of 97.1%. Conclusion Aeromonas sepsis is an important cause of death in patients with severe hepatitis. Fluoroquinolones and cephalosporins are currently the first choice of antibiotics for the treatment of Aeromonas infection. Early antibiotic treatment, prompt blood volume replacement and dehydration acidosis are the successful treatment key.