静脉曲张性溃疡临床特征分析

Analysis of clinical features of varicose skin ulcer

目的分析静脉曲张性溃疡的临床表现、细菌感染和药敏特征。方法对2011年1月—2015年1月确诊的92例静脉曲张性溃疡住院患者的临床资料进行回顾性分析。结果92例静脉曲张性溃疡患者中男68例,女24例,平均年龄61岁,静脉曲张平均病程15年,溃疡平均病程3.47年,溃疡平均面积10.37 cm2。41例细菌培养阳性患者中金黄色葡萄球菌占26.8%(11例),铜绿假单胞菌占21.9%(9例)。金黄色葡萄球菌对青霉素100%耐药,铜绿假单胞菌对医院常用抗生素如氨苄西林、头孢曲松、头孢呋辛钠等耐药。结论静脉曲张性溃疡好发于老年男性,病程和住院时间长,溃疡面感染细菌以铜绿假单胞菌、金黄色葡萄球菌为主,根据细菌分布及药敏分析,需要高度重视这些细菌种类的演变和耐药。

Objective To analyze the clinical characteristics, bacterial infection and drug sensitivity of varicose skin ulcer. Methods The clinical data of 92 patients with varicose skin ulcer admitted in our hospital from January 2011 to January 2015 were retrospectively analyzed. Results In all the 92 patients with varicose skin ulcer, male 68 cases, female 24 cases, average age was 61 years old. The average duration of varicose veins was 15 years, and the average duration of varicose skin ulcer was 3.47 years. Mean ulcer area was 10.37 cm2. In 41 cases of patients with bacterial culture positive result, Staphylococcus aureus accounted for 26.8%（11cases）, Pseudomonas aeruginosa accounted for 21.9%（9 cases）. Staphylococcus aureus resisting to penicillin was 100%. Pseudomonas aeruginosa was almost completely resistant to commonly used antibiotics such as ampicillin, ceftriaxone and cefuroxime sodium. Conclusion Varicose skin ulcer often occurs in older men with long duration. The top two kinds of bacterial infections were Pseudomonas aeruginosa and Staphylococcus aureus. According to bacterial distribution and drug sensitivity analysis, the evolution and drug resistance of these bacterial species should be highly valued.