盆腔、腹腔脓肿的病原学分析与临床处理

Pathogenic Analysis of Pelvic and Peritoneal Abscess and Its Clinical Management

目的探讨盆腔、腹腔脓肿的病原学和临床处理。方法对109例盆腔、腹腔脓肿临床资料进行回顾性研究,分析其病原学、抗菌药物选择、治疗时机及方式与预后的关系。结果109例盆腔、腹腔脓肿全部获得脓液培养加药敏,致病菌培养阳性75例,以大肠埃希菌感染为主,敏感药物以美罗培南及阿米卡星为主;手术治疗90例,术后复发4例,B超引导下盆腔脓肿经阴道穿刺引流9例,10例保守治疗痊愈,无死亡病例。结论盆腔、腹腔脓肿治疗应根据细菌培养结果及早选用敏感抗菌药物,及时手术切除原发病灶或脓腔充分引流可改善预后。

OBJECTIVE To explore the pathogenesis of pelvic and peritoneal abscesses and their clinical management. METHODS Clinical data of 109 patients with pelvic and peritoneal abscesses between 1999 and 2005 were retrospectively evaluated. The connection of their pathogenesis, antibiotics choice, and treatment types with prognoses was analyzed. RESULTS Pus from all patients was collected and sent to do germ culture and antibiotic susceptibility testing. Seventy five cases were with positive germ culture. The most germs were Escherichia coli and meropenem and amikacin were considered effective. Four cases were relapsed after surgery from 90 cases. Pelvic abscess drainage was performed through vagina under B type ultrasound guiding in 9 cases. Conservative treatment was given in 10 cases and no patient died. CONCLUSIONS Pelvic and peritoneal abscesses should be treated early with antibiotic according susceptibility testing to make a choice. And surgery or sufficient abscess drainage can improve their prognosis.