无症状期胆管结石病人的胆汁细菌学分析

Bacteriological analysis of bile in patients with cholelithiasis in the asymptomatic period

目的 探讨无症状期胆管结石病人的胆汁细菌构成特点。方法 择期胆道手术中获取病人胆汁作细菌培养。３２ 例胆管结石病人，按术前无症状时间１１２０ 天、２１３０ 天和３０ 天以上分Ａ、Ｂ、Ｃ３ 组，按胆管炎发作１ 次、２３ 次和３ 次以上分甲、乙、丙３ 组。结果 检出率排列前５ 位的细菌是大肠杆菌、脆弱类杆菌、肺炎杆菌、粘质沙雷氏菌和变形杆菌。Ａ、Ｂ、Ｃ 组的需氧菌和厌氧菌检出率为０－９２、０－６７、０－２１ 和０－６０、０－３３、０。组间差异显著。甲、乙、丙组的需氧菌和厌氧菌检出率为０－６３、０－５５、０－５４ 和０－４０、０－２９ 、０－３３。组间差异无显著性。结论 无症状期胆管结石病人的胆汁细菌检出率与无症状时间长短有关，与胆管炎发作次数无关。大肠杆菌、脆弱类杆菌、肺炎杆菌、粘质沙雷氏菌和变形杆菌是常见的５ 种细菌。

Objective To explore the bacteriological constitution feature of bile in patients with biliary calculus in the asymptomatic period. Methods Bacteriological culture was performed in 32 patients with cholelithiasis in the asymptomatic period. The patients were divided into groups A, B, C according to the duration of the preoperative asymptomatic period for 11-20, 21-30, >30 days and were also divided into groups Ⅰ,Ⅱ,Ⅲ according to the number of cholangitis attacks for 1, 2-3, >3 times, respectively. Results The leading five bacteria detected were Eschrichia, Pneumonobacilli, Proteus, Serratia and Fragilobacteroid, and the detection rates for aerobes in groups A,B,C were 0.92, 0.67, 0.21 and in groups Ⅰ,Ⅱ,Ⅲ were 0.63, 0.55, 0.54, for anaerobes in groups A, B, C were 0.60, 0.33, 0 and in groups Ⅰ,Ⅱ,Ⅲ were 0.40, 0.29, 0.33, respectively. Conclusion Eschrichia, pneumonobacilli, Proteus, Serratia and fragilobacteroid are the common bacteria in the bile of the patients with cholelithiasis in the asymptomatic period. The bile bacterial detectable rates have relation with the duration of asymptomatic period, but not with the number of cholangitis attacks.