肠瘘患者腔静脉导管感染的回顾性分析

目的了解肠瘘患者腔静脉导管感染的发生率、细菌菌谱及药敏情况。方法对1998年1月至2001年4月收治的使用腔静脉导管进行全肠外营养(TPN)的肠瘘患者进行回顾性分析。结果216例肠瘘患者,共进行了358次腔静脉置管,腔静脉导管尖端培养阳性的有88次(24.6%),腔静脉导管平均使用时间为(16.9±13.0)d。88次腔静脉导管感染的尖端共培养出95株细菌,其中革兰阴性菌54株,占56.8%;其次为革兰阳性菌35株,占36.8%;真菌6株,占6.4%。根据药物敏感试验结果及临床表现,有16例患者更换了抗生素,4例改用抗真菌药物,所有患者均治愈。结论对于肠瘘患者,腔静脉感染仍是实施静脉营养的主要并发症之一,革兰阴性细菌感染最常见。

Retrospective study of catheter associated infection in intestinal fistula patients

Objective To study the incidence,bacteria spectrum and drug sensitivity of catheter-associated infection(CAI )in patients with intestinal fistula.Methods Between January 1998and April2001,216patients with intestinal f istula were studied retrospectively.Results Among 358central venous catheters from 216patients,88cath eters(24.6%)presented definite CAI,and 95strains of bacteria were cultivated.54gram-negative bacte ria(56.8%),35gram-positive bacteria(36.8%)and 6fungus(6.4%)were found.According to drug sensitivity,antibiotic and antifungal we re changed in 16and 4patients respectively.All the patients were cured.Conclusion CAI is still the main complication du ring TPN treatment and gram-negative bacteria is most frequent in patients with i ntestinal fistula.