急性坏死性胰腺炎合并念珠菌感染

目的 探讨急性坏死性胰腺炎(ANP)合并念珠菌感染的诊治方法。方法 回顾分析78例ANP患者的临床资料,诊断由手术发现或cT检查确定,其中62例接受预防性抗生素治疗,16例未接受。每例均行血、尿、便、痰和创口引流液的培养和涂片镜检,检出念珠菌。结果78例ANP中共有14例发生念珠菌感染,发病率17．9％,死亡4例,死亡率28．6％;使用预防性抗生素组发病率19．4％,死亡率25．0％;未用预防性抗生素组的发病率12．5％,死亡率50．0％。结论 资料证明ANP合并念珠菌感染是一个值得重视的临床问题,预防性使用抗生素治疗ANP可预防严重继发性感染的发牛．但也同时会合并念珠菌感染。

Candida infection in patients with acute necrotizing pancreatitis

OBJECTIVE: To summarize our hospital's experience in the diagnosis and treatment of Candida infection in patients with acute necrotizing pancreatitis (ANP). METHODS: Seventy-eight cases with ANP were reviewed. There were diagnoses either by operative finding or by CT scanning. Sixty-two cases received prophylactic antibiotic treatment, other sixteen did not. For cultivation of Candida, blood, urine, stool, sputum and wound drainage fluid culture, and swabs were examined microbiologically for fungi. RESULTS: The incidence of Candida infection in all patients with ANP was 17.9% (14/78) and mortality was 28.6% (4/14). The incidence of prophylactic antibiotic group was 19.4% (12/62) and mortality was 25.0% (3/12). Non prophylactic group was 12.5% (2/16) and 50.0%. CONCLUSIONS: Our data provide evidence for the clinical significance of Candida infection in patients with ANP. The current prophylactic antibiotic treatment can prevent a septic course of the ANP, but might lead to the evolution of Candida infection.