胆结石并胆道感染患者病原菌分布及相关危险因素分析

Analysis of pathogenic bacteria distribution and related risk factors in patients with cholelithiasis and biliary tract infection

目的 分析胆结石并胆道感染患者病原菌分布情况及危险因素。方法 选取226例胆结石患者作为研究对象,分析临床资料,调查病原菌分布情况,总结患者胆结石并胆道感染的相关危险因素,并给予相应的干预对策。结果 226例胆结石患者中发生胆结石并胆道感染患者的有119例,感染发生率为52.65%。119例胆汁培养基结果呈阳性患者中共分离出137株病原菌,其中以革兰阴性菌(94株)为主,占比68.61%。多因素logistic回归分析结果显示,年龄、既往肝胆手术史、既往ERCP操作、肝硬化以及免疫功能低下均为诱发胆结石并胆道感染的独立危险因素(P<0.05)。结论 胆结石并胆道感染患者病原菌主要以革兰阴性菌为主,而高龄、有既往肝胆手术史和既往ERCP操作、肝硬化、免疫功能低下均会造成胆结石患者合并胆道感染,若采取积极有效的干预对策,可明显降低感染风险。

Objective To analyze the distribution and risk factors of pathogenic bacteria in patients with gallstones and biliary tract infection.Methods A total of 226 patients with gallstones were selected as the research objects.The clinical data were analyzed,the distribution of pathogens was investigated,the related risk factors of gallstones and biliary tract infection were summarized,and the corresponding intervention countermeasures were given.Results Among 226 patients with gallstones,119 patients had gallstones and biliary tract infection,and the incidence of infection was 52.65%.A total of 137 strains of pathogenic bacteria were isolated from 119 patients with positive bile culture medium,of which 94 strains were Gram-negative bacteria,accounting for 68.61%.Multivariate logistic regression analysis showed that age,previous hepatobiliary surgery,previous ERCP operation,liver cirrhosis and low immune function were independent risk factors for gallstones and biliary tract infection(P< 0.05).Conclusion The pathogenic bacteria of patients with gallstones and biliary tract infection were mainly Gram-negative bacteria.The elderly,previous hepatobiliary surgery,previous ERCP operation,liver cirrhosis and low immune function could all cause gallstones patients with biliary tract infection.If active and effective intervention measures were taken,the risk of infection could be significantly reduced.