THE BACTERIOLOGY AND SEPTIC COMPLICATION OF PATIENTS WITH APPENDICITIS
THE BACTERIOLOGY AND SEPTIC COMPLICATION OF PATIENTS WITH APPENDICITIS
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DOI：
10.1097/00000658-198411000-00003
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发表时间：
1984-01-01
影响因子：
9
通讯作者：
WONG, SH
中科院分区：
文献类型：
--
作者：
LAU, WY;TEOHCHAN, CH;WONG, SH
对 161 名接受阑尾炎手术的患者进行了详细的细菌学研究。需氧和厌氧培养物取自血液、阑尾腔、粘膜、浆膜、窝以及腹膜闭合后的伤口。阑尾炎的程度与血培养阳性的发生率没有相关性。随着疾病的进展，感染通过阑尾壁扩散。早期阑尾炎常见需氧菌感染，但晚期病例以需氧菌和厌氧菌混合感染为主。晚期阑尾炎、手术结束时伤口培养阳性、术前症状持续时间> 36小时以及患者年龄> 50岁均与脓毒症并发症发生率增加相关。从分离细菌对抗生素的敏感性来看，对抗厌氧菌最有效的药物是甲硝唑。对抗需氧菌的有效药物是氨基糖苷类和头孢菌素类。对抗厌氧菌和需氧菌的最佳单一药物是艾内酰胺。
A detailed bacteriologic study was done on 161 patients operated for appendicitis. Aerobic and anaerobic cultures were taken from the blood, the appendicular lumen, mucosa, serosa, fossa and from the wound after closure of the peritoneum. There is no correlation between the degree of appendicitis and the incidence of positive blood culture. The infection spread through the appendicular wall as the disease progressed. Aerobic infection was common in early appendicitis but a mixed aerobic and anaerobic infection was predominant in late cases. Late appendicitis, a positive wound culture at the end of the operation, the duration of symptoms of > 36 h before operation and the age of the patient > 50 yr were all associated with an increased incidence of septic complication. From the antibiotic sensitivity on the bacteria isolated, the most effective agent against anaerobes was metronidazole. Effective agents against the aerobes were aminoglycosides and cephalosporins. The best single agent against both anaerobes and aerobes was moxalactum.