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目的探讨急性盆腔感染患者的病原菌分布,探讨适当的干预对策。方法随机选取2010年1月至2015年12月本院收治的118例急性盆腔感染患者为研究对象,回顾性分析临床资料,血液标本或留取的盆腔标本的细菌培养结果,以及检测病原菌分布及药敏情况,分析该病的临床特点及抗生素疗效。结果共分离出病原菌58株,其中革兰阴性菌占55.17%(32株),革兰阳性菌占27.59%(16株),真菌占10.34%(6株)。有62例患者接受手术治疗或者有创引流,手术治疗或有创引流的患者与保守治疗的患者相比较,降钙素原、CA125、盆腔包块最大径、凝血功能异常发生率、升级抗生素的比例、感染性休克发生率、ICU入住率及住院时间等差异均具有统计学意义(P<0.05)。抗生素对于盆腔严重感染有效性依次为碳青霉烯类、万古霉素、四代头孢合用奥硝唑、合成青霉素类+β内酰胺酶抑制药、莫西沙星、三代头孢合用奥硝唑、二代头孢合用奥硝唑。结论引起女性严重盆腔感染最常见的细菌为大肠埃希菌,对氨苄西林及头孢曲松等药耐药率较高,最有效抗生素为碳青霉烯类。
Objective To investigate the distribution of pathogens in patients with acute pelvic infection and to explore appropriate intervention strategies. Methods A total of 118 cases of acute pelvic infection admitted to our hospital from January 2010 to December 2015 were selected as the research objects. The clinical data, blood samples or pelvic samples from the blood samples were collected and analyzed. Susceptibility, analysis of the clinical features of the disease and antibiotic efficacy. Results A total of 58 pathogens were isolated, of which Gram-negative bacteria accounted for 55.17% (32 strains), Gram-positive bacteria accounted for 27.59% (16 strains) and fungi accounted for 10.34% (6 strains). Sixty-two patients undergoing surgical treatment or invasive drainage, surgical treatment, or invasive drainage compared with conservatively treated patients, with procalcitonin, CA125, maximum pelvic mass, and incidence of coagulation abnormalities, The incidence of septic shock, ICU occupancy and hospital stay were all significantly different (P <0.05). The effectiveness of antibiotics for severe pelvic infection followed by carbapenems, vancomycin, cephalex combined with ornidazole, synthetic penicillins + β-lactamase inhibitor, moxifloxacin, third-generation cephalosporin combined with ornidazole, On behalf of cephalosporin ornidazole. Conclusions The most common bacteria causing severe pelvic infection in women is Escherichia coli. The rates of resistance to ampicillin and ceftriaxone are high, and the most effective antibiotics are carbapenems.