成批妇产科切口非结核分支杆菌感染

Group incisions infection from nontuberculous mycobacteria in gynecology and obstetrics

目的 探讨龟型非结核分支杆菌感染的妇产科切口的临床特点 ,总结治疗方法及效果 ,并提出新的临床分类 ,以指导治疗。方法 :据 139例感染切口的临床特点 ,分四型 (1)混合溃疡型 :118例 (84 9% ) ,(2 )单纯硬结型 :5例 (3 6 % ) ,(3)脓肿型 ,6例 (4 3% ) ,(4)淋巴结炎型 ,10例 (7 2 % )。切口感染潜伏期 10～ 5 0天最多。治疗 抗生素联用 ,分别以克拉霉素 ,丁胺卡那 ,阿奇霉素 ,泰能为主的 2～ 3联组合应用 4～ 6个月 ,切口愈合 ,B超二次检查(间隔 1个月 )切口正常后可停药 ;病灶切除术的 83例 ,仅以抗生素治疗的 5 0例 ,及未用任何药的 6例 ,切口全部治愈。结果 全部病例在 2～ 4个月内伤口愈合 ,停药后随访两个月 ,每月检查一次 ,伤口无硬结 ,积液 ,脓肿再发者为治愈。结论 成批龟型非结核性分支杆菌切口感染极为罕见 ,较难治疗 ,重在预防。

Objective: To investigate the clinical characteristics and effects of group incision infection from chelonei type nontuberculous Mycobacteria(NTM), and summarize a clinical classification for guiding the treatment Methods: According to the clinical characteristics, 139 cases infectious incisions were divided into 4 types: (1) mixed ulceration type, 118 cases(84 9%); (2) simple node type, 5 cases(3 6%); (3) lymphadenitis type,10 cases(7 2%); (4) abscess type,6 cases(4 3%) The incubation periods of infectious incisions were mostly 10～50 days Treatment: (1) applied antibiotics in combination: such main drugs as Clarithromycin, Amikacin, Azithromycin and Tienam were applied in combination, for 4～6 months, and drugs were stopped after 2 times(at an interval of 1 month) B Ultrasonic examination showed normal incisions (2) 83 cases lesion resection, 50 cases treated by antibiotics only and 6 cases taken no drugs were all recovered Results: All incision cases were cured in 2～4 months. After the drug use was stopped, twice ulfrasonic examinations were followed up for two months once in one month. Full recovery of incision occurred when there wasn't any lesion. Conclusion: Group incision infection from chelonei type nontuberculous mycobacteria is rare, but difficult to treat and stress should be put on prevention