肝惡性腫瘤合并產(chǎn)氣莢膜梭菌血流感染1例并文獻(xiàn)回顧

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Acase of hepatic malignant tumor with Clostridiumperfringens bloodstream infection and literature review WuYa，Xu Kaiyue，LiuYuanyuan，ZhengYa.DepartmentofClinical LaboratoryHebei ProvincialHospitalof Traditional Chinese Medicine，Hebei O5oo11，

【Abstract】 ObjectiveToanalyze the clinical characteristicsand changes in laboratory examination indexesof Clostridium perfringens bloodstream infection，and providea basis forrapidclinical diagnosisand treatment.MethodsAcase with a hepatic malignant tumor complicated with Clostridiumperfringens bloodstream infection was reported.The relevant literature on Clostridium perfringens bloodstream infection was searched.Then itsclinicaland laboratorycharacteristicswere analyzed based on thecase.ResultsClostridium perfringenswere isolated fromthebloodof thispatient witha hepaticmalignanttumor.Aftersymptomaticandanti-infectious treatment，thefataloutcomecouldnotbesaved.Atotal of28caseswith Clostridium perfringens bloodstream infectionwere retrieved in National Knowledge Infrastructure.Of the28 cases，there were1O cases improved，17 casesdied，1 case hadan unknown prognosis，and9cases were accompanied by liver absces formation.Among them，4patientswith livercancer were complicatedwith Clostridium perfringensbloodstream infectionafter operation，which caused severe intravascular hemolysis.Thepatients‘condition deteriorated rapidly andthe prognosiswas poor.This wasconsistent with this case report.ConclusionItis recommended thatif patientshave risk factors of anaerobic bloodstream infection，including male，old age，cancer，chronic liver disease，etc，accompanied bysuddenintravascularhemolysis，experiential antibiotictreatmentand surgical resectionof infection focus shouldbecaried out assoon as possible toreduce the high mortalitycausedby Clostridium perfringens bloodstream infection.

【Key words】Liver neoplasms； Clostridium perfringens；Bloodstream infection；Toxins； Intravascular hemo-lysis

產(chǎn)氣莢膜梭菌（Clostridium perfringens）是專性厭氧的革蘭陽性芽孢桿菌，是一種條件致病菌，可引起各種感染，包括食物中毒、氣性壞疽、蜂窩織炎和筋膜炎，由產(chǎn)氣莢膜梭菌引起的血流感染很少報(bào)道，其引起血流感染所占比例約為 0.017%[2]. 但常發(fā)展為快速進(jìn)展的血管內(nèi)溶血和代謝性酸中毒，病死率高達(dá) 70% 以上[34]。（剩余8294字）