重症急性胰腺炎继发感染性胰腺坏死的病原学特点及相关因素分析

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Etiologicalcharacteristicsandrelated factorsof secondary infected pancreatic necrosisin severe acute pancreatitisLinQun，LiHe.DepartmentofEmergencySurgery，TheSecondAffliated HospitalofAnhuiMedical University，Anhui230601，China

【Abstract】ObjectiveTo investigate the etiological characteristicsand related factors of secondary infected pancreatic necrosis （IPN） insevere acute pancreatitis（SAP）.MethodsThe clinical dataof 88 SAP patientsadmited to the emergency surgery department of our hospital from April2O21 to April 2024 were retrospectively colected.The patients were divided into an infected groupandan uninfected groupaccording to whether theyhad secondary IPNduring hospitalization.Theetiological characteristicsandrelated factorsof secondary IPN in SAP patients were analyzed.ResultsAmong the 88 patients with IPN，35 （40% ）developed secondary IPN.A totalof59pathogenicbacteriaweredetected in35IPNpatients，including46Gram-negative bacteria （7 8% ），11 Gram-positive bacteria （19 % ）and2 fungi （3% ）.A total of30 strains （51%） of drug-resistant bacteria were detected.Comparative analysis between the two groups showed that starting the enteral nutrition time，modified CT severity index （MCTSI），abdominal puncture drainage （APD），multiple organ failureand procalcitonin in the infected group had statistical significance compared with the non-infected group （ P <0.05）. Multifactor analysis showed that starting the enteral nutrition time 37 days and MCTSI>8 points were independent risk factors for secondary IPN in SAP patients （P<0.05） .ConclusionGram-negative bacilli were the main secondarypathogens of IPN in SAP patients，and most of them were drug-resistant bacteria.Starting theenteral nutritiontimeand MCTSIasindependent risk factors for IPNsecondaryto SAP should be emphasized in prevention and treatment evaluation.

【Key words】 Severe acute pancreatitis；Infected pancreatic necrosis；Etiological characteristics

急性胰腺炎（acutepancreatitis，AP）是急诊外科常见急腹症，大多数病例是轻症的，具有自限性。（剩余6867字）