十二指肠引流对慢性重型肝炎胆道感染治疗的影响

目的了解十二指肠引流对慢性重型肝炎胆道感染治疗的影响及慢性重型肝炎胆道感染的细菌分布。方法在胃镜引导下行十二指肠引流，并对胆汁进行细菌培养及药敏试验，根据药敏试验选择敏感抗生素进行治疗。结果慢性重型肝炎的胆汁细菌培养的阳性率高达93．30％；细菌以G^-杆菌为主，占55．93％，其次G^＋球菌，占27．97％。真菌占16．10％；行十二指肠引流后有针对性地使用敏感抗生素进行治疗的慢性重型肝炎组治愈率74．30％．而未进行十二指肠引流组的慢性重型肝炎治愈率仅51．48％。结论慢性重型肝炎合并胆道感染时使用十二指肠引流找出病原菌。有针对性地使用抗生素能明显提高慢性重型肝炎的治愈率。

The Influence of Duodenal Drainage on the Treatment of Biliary Tract Infection in Chronic Severe Hepatitis

Objective To study the influence of duodenal drainage on the treatment of biliary tract infection in chronic severe hepatitis, and the occurrence of the bacterial species. Method Duodenal drainage was conducted using a gastroscope. Biliary bacteria were cultured and tested for drug susceptibility. Appropriate antibiotics were selected according to the results of the drug susceptibility test. Result For the patients with chronic severe hepatitis, the positive rate of biliary bacterial culture was 93.30%. 55.93% of the isolated bacteria were Gram-negative bacilli, and 27.97% were Gram-positive coccobacteria. 16.10% were fungal isolates. The cure rate for the treatment and control group was 74.30% and 51.48%, respectively. Conclusion For the patients with chronic severe hepatitis complicated by the biliary tract infection, the cure rate would be significant increased by treatment with appropriate antibiotics.