摘要
本文对65例胆红素钙结石患者胆汁和胆囊粘膜进行定性和定量细菌学观察。细菌总检出率93.8%,需氧菌检出率为92.3%,厌氧菌检出率为73.8%。厌氧菌在有菌胆道中占78.7%,在原发性肝胆管结石和急性梗阻性化脓性胆管炎病例中占89.5%和95.7%。胆汁中各检出菌数均≥10~5CFU/ml,厌氧菌数高于需氧菌数。主要检出菌是大肠杆菌、肺炎克雷伯氏菌、脆弱拟杆菌和产气荚膜梭菌,符合内源性感染。胆道厌氧菌感染的临床特征包括:高龄、病史长且复杂、胆道手术史、临床症状体征重、肝胆管结石、需要急症手术及急性梗阻性化脓性胆管炎。
The bile and gallbladder mucosa from 65 consecutive calcium bilirubinate stone(CBS)subjects undergoing biliary tract surgery were examined for the quality and quantity of bacteria exploying improved anaerobic culture tecniques.The incidence of bacteria from the bile duct was 93.8%. 92.3% of bile duct(bile and gallbladder mucosa)with CBS yielded aerobic bacteria.73.7% of bile duct with CBS,89.5% of bile duct with primary common bile duet stone and 95.7% of bile duct with acute obstructive suppurative cholangitis(AOSC)yielded anaerobic bacteria on culture.The incidence of anaerobic bacteria from bile buet was higher than that in the previous reports.The numbers of bac- teria all exceeded 10~5 colony forming units(CFU)per ml of bile.The most commonly cultured organ- isms were E.coli,K.pneumonia,B.fragilis snd C.perfringens.The prominent features of anaerobic bacteria included previous surgery,longer clineal history,sever symptoms,common bile duct stone and AOSC.
