食管气管瘘合并下呼吸道感染的病原学特点

Pathogenic characteristics of esophagorespiratory fistula complicated with lower respiratory tract infection

目的 探讨食管气管瘘合并下呼吸道感染的临床特点及病原菌分布。方法 连续收集煤炭总医院 2014 年 1 月至 2016 年 12 月呼吸科收治的 52 例食管气管瘘患者的临床资料。结果 我院52 例食管气管瘘患者均合并下呼吸道感染,原发病均为恶性肿瘤,临床症状以进食水后呛咳为主要表现, 73.1% 的患者有放疗和/或化疗史,多有不同程度的贫血和低蛋白血症,92.3% 的患者在入院前使用抗菌药物治疗,瘘口位置以气管 3 区和 7 区多见,病原学培养以革兰阴性菌和真菌为主,分别占64.71% 和 25.49% ,其中以铜绿假单胞菌最为常见。结论 食管气管瘘易合并下呼吸道感染,明确病原菌,有利于合理选择抗生素。

Objective To investigate the distribution of pathogens and clinical features of esophagorespiratory fistula complicated with lower respiratory tract infection. Methods A total of 52 patients with esophagorespiratory fistula in China Meitan General Hospital were collected during January 2014 to December 2016. Results All of the 52 cases of esophagorespiratory fistula patients were complicated with lower respiratory tract infection and primary disease which were malignant tumor. The main clinical manifestations were choking cough after drinking and eating. 73.1% of the patients had a history of radiotherapy and/or chemotherapy, varying degrees of anemia and hypoproteinemia, 92.3M of which were treated with antibiotics before admission. Distribution of fistula was mostly in trachea District 3 and 7. Pathogen culture was dominated by Gram negative bacteria and fungi, accounted for 64.71M and 25.49M respectively, in which Pseudomonas aeruginosa was the most common. Conclusions The esophagorespiratory fistula is easy to be combined with lower respiratory tract infection. Understanding of the pathogen is conductive to the rational choice of antibiotics.