论文部分内容阅读
目的分析危重烧伤患者病原菌构成特点及临床预后。方法危重烧伤患者48例,Ⅲ°烧伤面积≥90%;其中,存活22例(A组),死亡26例(B组)。回顾性总结患者痰液、创面分泌物、血液、尿液和静脉导管尖端标本的菌株培养资料,分析两组病原菌构成特征和影响患者预后的因素。结果共分离出病原菌2816株:革兰阴性杆菌2640株(93.75%),主要为铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌;革兰阳性球菌56株(1.99%);真菌120株(4.26%)。呼吸道、创面、血液是危重烧伤患者感染的主要部位。与A组比较,B组受损脏器数、病原菌种类和抗菌药物使用种类多,首次切痂时间延迟(P<0.05)。结论危重烧伤患者感染的病原菌以革兰阴性杆菌为主。感染、多脏器功能衰竭和手术等因素可影响危重烧伤患者的预后。
Objective To analyze the characteristics and clinical prognosis of pathogenic bacteria in critically ill patients with burn. Methods Forty-eight patients with severe burn and Ⅲ ° burn area ≥ 90%. Among them, 22 patients survived (group A) and 26 patients died (group B). The clinical data of sputum, wound exudates, blood, urine and venous catheter tip specimens were retrospectively analyzed. The characteristics of pathogenic bacteria composition and the prognosis of patients were analyzed. Results A total of 2816 pathogens were isolated: 2640 strains (93.75%) of Gram - negative bacilli, mainly Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae; 56 strains (1.99%) of Gram - positive cocci; 120 fungi (4.26%). Respiratory tract, wound, blood is the main part of the infection of critically ill patients. Compared with group A, the number of organs damaged, the types of pathogens and the use of antimicrobial agents in group B were more than those in group A, and the time of initial scabbing was delayed (P <0.05). Conclusion Gram-negative bacilli are the main pathogens in patients with severe burn. Factors such as infection, multiple organ failure and surgery can affect the prognosis of critically ill patients.