Objective To prove the necessity of precise red blood cell transfusion by studying the frequency of double population of Rh blood group C and E antigen after allogeneic red blood cell transfusion in our hospital and its influence on blood transfusion efficacy. Methods From June 2021 to March 2022, 296 blood recipients, transfused with ABO homogeneous but RhC/E phenotypes unknown 2U-RBC suspension, were enrolled from Beijing Jishuitan Hospital, and the ABO, RhD, RhC, RhE blood type before transfusion and double population frequency of C and E antigens after transfusion were detected. Patients with RhC and E not changed in comparison with pre-transfusion were set as group A(n=135), with RhC becoming double population as group B (n=18), with RhE becoming double population as group C (n=116), and with both RhC and RhE changed to double population as group D(n=27). The levels of red blood cell (RBC), haemoglobin (Hb) and hematocrit (HCT) before and after blood transfusion were compared among the four groups. Results The negative rates of RhD, RhC and RhE in 296 patients were 0.34%(1/296), 20.27%(60/296) and 67.57%(200/296), respectively. There were 17 cases out of positive screening for unexpected antibodies, among which 7 cases were of anti-E, with the highest proportion. After RBCs transfusion, the double population frequencies of C and E antigens were 15.20%(45/296) and 48.31%(143/296), respectively. The levels of RBC, Hb and HCT in group A, B, C and D were significantly increased, and the difference was statistically significant (P<0.05). There were significant differences in the elevations of RBC and HCT among the four groups (P<0.05), and the elevations of RBC, Hb and HCT were all group A > group C > group B> group D. Conclusion The Rh blood group C and E antigen double population has an significant influence on the efficacy of blood transfusion.

目的 本研究旨在术前确定与原发恶性骨肉瘤手术患者术中输血相关的高危影响因素,为新冠肺炎疫情持续存在期间如何科学合理制定骨肉瘤术前备血计划提供参考依据.方法 回顾性分析北京积水潭医院2020年1月～2021年1月骨肿瘤科原发恶性骨肉瘤手术患者的病例资料120份,收集患者的一般资料、术前血常规及凝血资料、临床病理资料及手术相关资料,通过单因素分析、多因素回归分析确定原发恶性骨肉瘤患者术中输血的高危险因素.结果 1)原发恶性骨肉瘤患者术中输血率为48.33％(58/120),平均输血量为(1.36±1.14)U;术后输血率为62.50％(75/120),平均输血量为(2.93±2.26)U;2)单因素分析:性别、术前Hct、术前Plt、病变位置、Huvos分级、切口长度、重建长度及术中出血量等因素,P＜0.05;3)多因素Logistic回归分析:性别、病变部位、Huvos分级、切口长度、重建长度及术中出血量等因素,P＜0.05.结论 对于术中输血率极高的原发恶性骨肉瘤,应针对患者术中输血的高危因素进行提前干预,精准制定患者术前备血计划,在保障手术安全的前提下有效降低输血率及输血量.

目的 分析术中回收式自体输血对骨盆骨折手术患者的影响.方法 选取北京积水潭医院在2019年12月至2020年12月期间收取的61例骨盆骨折手术患者,按输血方式分为两组,对照组27例,术中采用异体输血,其中男16例,女11例;年龄7～84岁,平均(49.82±5.63)岁;观察组34例,术中采用回收式自体输血,其中男19例,女15例;年龄15～66岁,平均(50.10±5.65)岁;比较两组术中失血量、输血量及凝血功能指标.结果 两组术后心率(heart rate,HR)均增加,手术前后比较,差异具有统计学意义(P＜0.05),两组术后平均动脉压(mean artery pressure,MAP)、中心静脉压(central venous pressure,CVP)与术前比较差异无统计学意义(P＞0.05);两组术后即刻、术后3d凝血酶原(prothrombin,PT)、部分活化凝血活酶时间(activated partial thromboplastin time,APTT)与术前比较差异无统计学意义(P＞0.05),术后3d血浆纤维蛋白原(Fibrinogen,FIB)增加,与术前比较差异具有统计学意义(P＜0.05),对照组在术后即刻以及术后3 dFIB有所增加,与术前比较差异有统计学意义(P＜0.05),两组不同时相点比较差异无统计学意义(P＞0.05).两组在术后即刻、术后3d血红蛋白、红细胞压积(red blood cell specific volume,Hct)降低,术后3d时血红蛋白及血小板计数(platelet count,PLT)升高,且与术前比较差异有统计学意义(P＜0.05),但两组不同时相点血常规指标比较差异无统计学意义(P＞0.05).观察组自体输血量高于对照组,异体输血量低于对照组,差异有统计学意义(P＜0.05).结论 术中回收式自体输血可减少术中的异体输血量,对凝血指标无明显影响,具有较高的应用价值.

Objective To explore the application of the indicator system of disease diagnosis related groups (DRGs) on the management of clinical blood use in hospitals. Methods Statistics information on clinical blood use as well as DRGs indexes including case mixed index (CMI), DRG grouping and corresponding weights among patients discharged during 2017 to 2019 from a hospital were recorded. RBC usage per 100 discharged patients after CMI adjustment and DRGs with a larger number of annual blood use cases were compared to make recommendations on the management of clinical blood use in the hospital. Results From 2017 to 2019, the number of blood users and patients discharged from our hospital kept growing, while the total blood use, RBC usage per 100 discharged patients after CMI adjustment showed a decreasing trend. There were 6 DRGs with the top five blood users from 2017 to 2019, and the top five DRGs accounted for 0.79%(5/629)in 2019, involving 1 611 blood use cases, accounted for 37.49%(1 611/4 297)of all cases of blood use in the year. Conclusion The application of the indicator system of DRGs to evaluate the clinical use of blood in hospitals is conductive to improve the rationality of clinical blood use, and can provide recommendations for the management of clinical blood use.

目的 探讨与烧伤患者住院期间输血相关的影响因素,为临床制定个体化的输血治疗方案提供参考依据.方法 回顾性分析自2015年1月～2019年1月纳入本研究的火焰烧伤患者116例、高压电烧伤患者46例.统计两组患者的性别、年龄、身高、体重、体质指数BMI(body mass index,BMI)、烧伤面积、烧伤深度、烧伤部位、术中出血总量、术后引流量、手术次数、总住院天数、输血量、是否合并吸入性损伤、是否合并应激性溃疡、是否合并感染、是否合并高血压、糖尿病、是否合并心脏相关疾病、是否合并肝肾功能异常及是否合并低蛋白血症等因素.以P＜0.05为差异有统计学意义.结果 住院期间的平均输血量:火焰烧伤患者(29.26±26.18)U明显高于高压电烧伤(13.26±10.32)U.输血前平均血红蛋白浓度(g/L):火焰烧伤患者(91.49±15.11)g/L明显高于高压电烧伤(81.70±14.49)g/L;火焰烧伤与高压电烧伤患者在性别、BMI、烧伤面积、烧伤深度、烧伤部位等方面的差异具有统计学意义(P＜0.05);当患者烧伤面积越大、累及躯干、手术次数≥6次、总住院天数≥100 d、术中总失血量≥2 000 mL、合并高血压、合并心脏相关疾病、合并肝肾功能异常及合并低蛋白血症等因素时将显著影响患者住院期间的平均输血量(P＜0.05),其中术中失血总量对火焰烧伤患者的影响最为显著(r=0.60 P＜0.05),烧伤部位对高压电烧伤患者的影响最强(r= 0.44P＜0.05).结论 烧伤面积越大,烧伤深度越深,烧伤部位累及重要脏器和/或大血管,住院期间手术次数≥6次,术中失血量总和≥2 000 mL的严重烧伤患者住院期间的平均输血量大;当患者合并高血压、严重心和肝肾功能异常及低蛋白血症等因素时是患者住院期间输血量增加的高危因素,需得到临床医师高度重视.

目的 了解影响老年髋部骨折围术期输血的相关因素,为临床制定个体化输血方案提供参考依据.方法 收集本院2018年3月-2019年2月1年的骨科住院老年髋部骨折手术围术期输血患者的病历882(人)份,纳入患者的性别、年龄、体质指数(BMI)、骨折类型、合并基础疾病、受伤至就诊时间、入院首次血红蛋白(Hb)、抗凝药物服药史、手术方式、美国麻醉医师协会(ASA)麻醉分级、术中出血量、术后引流量、术后Hb等指标做与输血的单因素分析;将其中各指标(P＜0.05与P≥0.05)汇拢做多因素Logistic回归分析,确定老年髋部骨折手术患者围术期输血的高危因素.结果 1)围术期输血率:股骨颈骨折手术为33.20％(166/500),股骨粗隆间骨折手术为70.16％(268/382).2)单因素分析:患者的年龄、BMI、骨折类型、入院首次Hb、合并其他心脑血管疾病(除高血压外,如冠心病、脑卒中等)、合并糖尿病、有抗凝药物服药史、手术方式、ASA麻醉分级、术中出血量、术后引流量及术后Hb皆可能影响围术期输血(均为P＜0.05).3)多因素Logistic回归分析:患者的性别、年龄、骨折类型、合其他并心脑血管疾病、有抗凝药物服药史、入院首次Hb、手术方式、ASA麻醉分级、术中出血量及术后Hb等共同对围术期输血发挥了作用(P＜0.05).结论 骨折类型是影响老年髋部骨折患者围术期输血的关键因素;女性、高龄、合并心脑血管疾病、有抗凝药物服药史、入院首次Hb、ASA麻醉分级、术中出血,术后Hb等因素与老年髋部骨折患者围术期输血高度相关,在制定个体化的输血治疗方案时应当高度重视这些因素.

目的 分析引起疑难配血的成因,探讨科学有效的解决方法.方法 调查2015年1月-2017年12月的181例疑难配血,结合同时期的8 247例输血前检测试验结果,分析造成疑难配血的主要原因及配血策略探讨.随机抽取307例近期(2周内)在本院有输血史的患者标本进行RhE与RhC血型检测,以分析RhC,RhE盲选情况下的的匹配情况.结果 181例疑难配血中,供血者抗筛阳性4例(抗-E),供血者直抗阳性2例;备血患者抗筛阳性175例,其中自身抗体24例,同种抗体151例(抗-RhE 129例).8 247例备血患者中RhE阴性4179(50.7％)例,RhE阳性4 068(49.3％)例;RhC阴性975(11.8％)例,RhC阳性7 272(88.2％)例;近期(2周内)在本院输过血的备血患者307例中,双群162例(52.8％),其中RhE血型双群121例(121/162),RhC血型双群42例(42/162),RhC和RhE同时双群1例.结论 Rh血型同种抗体是造成疑难配血的主要原因.ABO血型和Rh(C.c.D.E.e)血型同型输血同型输血,可以最大程度降低疑难配血的发生率.

目的:调查同期双侧膝关节置换与选择性单侧膝关节置换手术的用血情况,归纳此2种手术的用血特点,为原发性膝关节病手术方案评估提供参考.方法:对近3年的4 384例人工膝关节置换术患者进行回顾性调查,对同期双侧全膝关节置换与选择性单侧全膝关节置换的用血情况进行分析,归纳总结该2种手术用血特点.结果:1 316例同期双侧全膝关节置换术患者,用血275例,人均用血量0.66 U,用血患者人均用血量3.15U,用血概率20.90％,平均住院日9.19d,人均费用6.25万元;3 068例选择性单侧全膝关节置换患者,用血228例,人均用血量0.18U,用血患者人均用血量2.48 U,用血概率7.43％,平均住院日8.56d,人均费用10.22万元.结论:①同期双侧全膝关节置换术人均用血量和用血概率显著高于选择性单侧膝关节置换术(P＜0.05).②原发性双侧膝关节病进行分期双侧(择期2次单侧)膝关节置换的平均住院日和平均住院费用显著高于同期双侧全膝关节置换(P＜0.05).

目的 老年人工全髋关节置换术与全膝关节置换术后隐性失血的相关分析.方法 选取2018年1月-2019年6月96例北京积水潭医院收治行择期人工全髋关节置换术与全膝关节置换术的老年患者,根据患者术式分为全髋置换组(43例)和全膝置换组(53例).根据术中出血记录及术后引流记录计算围手术期失血量,观察两组患者显性与隐性失血情况,并制定相应的输血策略.结果 两组患者在围手术期失血量以及术前血红蛋白水平比较差异无统计学意义,但全髋置换组在隐性失血量、术后血红蛋白水平方面明显优于全膝置换组(P<0.05);全膝置换组中有20例患者采取术中自体血回输处理,而自体血回输患者的实际红细胞丢失量明显低于未采取自体血回输患者(P<0.05).结论 全膝关节置换术患者在围术期的隐性失血量相对于全髋关节置换术更高,因此需要密切观察患者血液细胞检测结果,制定科学的输血策略,避免贫血等并发症的出现.

Objective:To detect and analyze RhE antigen and the development of anti-E antibody among patients who RhE antigen was negative and received RhE antigen-positive blood,so as to provide fact based guidance for clinical blood transfusion.Method:For the blood samples of 2 395 patients received blood transfusion in our hospital from January 1,2016 to September 30,2016,ABO blood typing,RhD,RhC,and RhE antigen measurement were performed,irregular antibody screening and detection were performed at the same time.RhE antigen was tested on samples of blood that were transfused to RhE antigen negative patients.Blood samples from RhE negative patients whom tested irregular antibody screening positive were further subjected to antibody measure ment tests.Result:Among the 2 395 patients who received blood transfusion,45.1 ％ (1 081/2 395) were RhE antigen negative,1.3 ％ (31/2 395) were irregular antibody screening positive.Among these 31 patients,58.1％ (18/31) were tested anti-E antibody positive.1.4％ (5/352) RhE negative patients developed anti-E antibody after received RhE positive blood transfusion.Conclusion:It is necessary to perform RhE antigen matching in addition to ABO and RhD blood type matching in cases of patient blood transfusion.

目的:分析某三甲医院2011至2015年临床用血的情况,了解该院临床用血的合理性.方法:对2011至2015年某三甲医院临床上血制品的使用量、出院的人数及手术人次等临床数据进行调查统计.分析2011至2015年该院使用血制品的总体趋势及各月份、各季度、各科室使用血制品的特点.结果:除2012年血制品的用量有1.3%的小幅增长以外,2011至2015年该院血制品的用量呈大幅下降的趋势.2011至2015年,该院每年的出院患者和手术人次均持续增多.该院的出院患者人均使用血制品0.53 U.该院的手术患者台均红细胞的使用量为0.7 U.2011至2015年,该院每年红细胞使用量最高的三个月份是3月份、4月份和5月份,每年红细胞使用量最少的两个月份是1月份和2月份.2011至2015年该院使用红细胞数量居前五的科室为矫形科、创伤科、骨肿瘤科、急诊科和ICU科.这5个科室共使用红细胞72607 U,占所有科室红细胞使用量的65%.结论:近年来,该院各科室血制品的用量并没有随着收治患者数量的增加而增多,反而有所降低.该院对血制品的管理较规范,临床用血的情况较合理.

疑难血型以及意外抗体的鉴定是干扰临床交叉配血的重要因素,现将我院外送北京市血液中心的16例疑难血型及36例意外抗体鉴定共52份标本检测结果报告如下。1临床资料我院2011-01-2015-12送北京市血液中心的16例疑难血型及36例意外抗体鉴定共52份标本进行检测。2结果在16例血型鉴定标本中以A型标本常见,占56.25%,见表1。36例意外抗体鉴定标本中,34

Objective To investigate the value of detection of anti-cyclic peptide containing citrulline (anti-CCP) antibody, rheumatoid factor (RF) and the combined detection of anti-CCP antibody and RF in rheumatoid arthritis (RA) patients. Methods From 2012 to 2014,1 961 patients were divided into three groups:diagnosed RA group(509 patients), not RA group(1 028 patients) and firstly was not diagnosed RA but later was diagnosed RA group (424 patients). The levels of RF and anti-CCP antibody were separately measured by rate nephelometry method and the electrochemical luminescence method. Results The sensitivity of detecting by anti-CCP antibody alone or anti-CCP antibody in combination with RF between RA group and not RA group was not significant difference ( P>0.05), but the specificity between two groups (88.6%vs. 60.4%) was significant difference ( P<0.05). There were significant differences in the sensitivity (81.7% vs. 74.3%) and specificity (88.6% vs. 66.0%) between by using anti-CCP antibody alone and RF alone.In firstly was not diagnosed RA but later was diagnosed RA group, there were significantly difference in sensitivity (98.3%vs. 82.1%) and specificity (91.6%vs. 81.5%) by using anti-CCP antibody alone and RF alone. Conclusion There is important clinical value by using anti-CCP antibody alone for the early diagnosis of RA.

Objective To analyze homocysteine in patients with acute cerebral infarction and related indicators of coagulation and fibrinolysis,diagnosis and treatment of acute cerebral infarction in order to provide reference for the disease.Methods Paitents with acute cerebral infarction from April 2012 to June 2014 were selected,they were divided into acute cerebral infarction groups and non acute cerebral infarction,,The acute cerebral infarction patients and non-patients with acute cerebral infarction group 1 ∶1.homo-cysteine and related indicators of coagulation and fibrinolysis were compared between two groups.Results Non-acute cerebral in-farction group homocysteine(Hcy),D-dimer,tissue-type plasminogen activator(t-PA),plasminogen activator inhibitor-1 (PAI-1 ) levels were significantly lower than in acute cerebral infarction group;non-acute cerebral infarction group(INR),significantly higher than the acute cerebral infarction group,the difference was statistically significant(P <0.05);after treatment of acute cerebral in-farction group,progress group Hcy,D-dimer,t-PA,PAI-1 was significantly higher than non-progression group;progressive group of international normalized ratio (INR),activated partial thromboplastin time(APTT)was significantly lower than non-progressive group,the difference there was statistically significant(P < 0.05 );good prognosis group D-dimer,t-PA,PAI-1 were significantly lower than a poor prognosis group,the difference was statistically significant(P <0.05)Conclusion Detection Hcy and related indi-cators of coagulation and fibrinolysis can effectively determine the content of the disease in patients with acute cerebral infarction, prognosis and progress,prognosis D-dimer and patients.

目的 研究血清甲胎蛋白(AFP)、高尔基体蛋白73(GP73)和α-L-岩藻糖苷酶(AFU)联合检测在原发性肝细胞癌(HCC)诊断中的临床价值.方法 将研究对象分为原发性肝细胞癌(HCC)组,肝硬化组及健康对照组,检测血清AFP、GP73和AFU水平,并对各组结果进行统计学分析.结果 结果显示HCC组AFP、GP73及AFU水平均显著高于其他组,单独检测时血清AFP、GP73和AFU的敏感性分别是52％、74％和55％,特异性分别是93％、95％和88％,联合检测敏感性及特异性分别为93％和86％.结论 AFP、GP73及AFU联合检测可显著提高HCC诊断的敏感性,在HCC的早期诊断中具有重要的临床应用价值.

目的:检测和分析RhD(-)孕妇外周血中抗D抗体效价,评价新生儿溶血病(HDN)的发生率.方法:收集北京积水潭医院和北京大学人民医院2012-2013年的RhD(-)孕妇外周血,采用血清学方法对所有标本进行Rh血型鉴定,谱细胞进行抗体检测和鉴定,并检测抗D抗体效价.结果:孕妇外周血中抗D抗体的检出率为8.6％,有既往妊娠史的孕妇抗D抗体的检出率明显高于第一次妊娠的孕妇.结论:产前检测和分析RhD(-)孕妇体内的抗D抗体,可以预测HDN发生的概率.

OBJECTIVE:Calibrated Automated Thrombogram(CAT) is a test to monitor the generation of thrombin. It can be described by four parameters: lag time, peak thrombin, endogenous thrombin potential (ETP) and time to peak (ttPeak). This study aims to determine the normal ranges of CAT parameters in Chinese, and evaluate whether thrombin generation is correlated with the concentration of heparin/low molecular weight heparin.METHODS:Plasma from 120 healthy subjects were collected to determine the normal rangea of CAT parameters in Chinese. Normal plasma pool (NPP, n=25) spiked with different concentrations of heparin or enoxaparin were used to detecte CAT parameters. The overall and age specific normal ranges of CAT parameters were calculated using descriptive statistics method with mean±2SD. The correlation between CAT parameters and age or concentrations of heparin, enoxaparin were analyzed with linear regression model.RESULTS:The normal ranges for lag time, peak thrombin, ETP, ttPeak in the subjects were 3.648±2.465 min, 367.39±151.93 nmol/L, 2277±1030 nmol/L•min and 6.372±4.280 min respectively. Age was linearly correlated with lag time (r=-0.6583, P<0.0001), peak thrombin (r=0.4863, P<0.0001), ETP (r=0.3608, P<0.0014) and ttPeak (r=-0.6313, P<0.0001). The values of ETP/peak ratio were linearly correlated with concentrations of heparin.CONCLUSION:The normal ranges of four CAT parameters for Chinese were determined. CAT parameters are associated with age. ETP/peak ratio could be used to monitor the process of anticoagulation therapy.

Objective To evaluate the effectiveness of using anti-CCP as the single laboratory parameter for RA diagnosis,versus to use anti-CCP,RF,and other parameters in combination.Material and methods level of RF was measured by rate scattering turbidimetry method;anti-CCP level was measured by ELISA;level of AKA and APF were measured by indirect immunofluorescent assay.Results For diagnosis of RA,there's no significant difference in sensitivity between anti-CCP and RF(P0.05),However,specificity of anti-CCP is significantly higher than RF(P 0.05).Compared to AKA and APF,the sensitivity of anti-CCP measurement is significantly higher(P0.05),with no significant difference in specificity.Compared to using anti-CCP alone,to use both anti-CCP and RF for RA diagnosis, there was no significantly improvement of sensitivity,whereas the specificity dropped significantly.To use anti-CCP in combination with either AKA or APF,there were no significant changes in both the sensitivity and specificity.AntiCCP in combination with RF,with AKA,and with APF,compared to anti-CCP alone,had significantly lower specificity(P0.05).Compared with anti-CCP alone,when anti-CCP measurement was combined with all three other parameters(RF,AKA,and APF),there was no significant difference in specificity,but sensitivity was significantly lower(P 0.05)Conclusion anti-CCP level alone for RA diagnosis is more effective than RF measurement;combination of antiCCP measurement with RF,AKA,and APF did not significantly improve the sensitivity and specificity.We recommend that anti-CCP measurement alone is sufficient and can replace RF measurement for RA diagnosis.

Objective To monitor the distribution of pathogenic bacteria causing wound infection in trauma patients and their susceptibility to antibiotics in an effort to offer evidence for the rational clinical use of antibiotics.Methods Pathogens were identified by expressive type,but a very few was determined by the molecular methods.Micro-dilution or Kirby-Bauer method for minimum inhibitory concentration (MIC) was adopted for drug susceptibility test.Results A total of 121 species of pathogens numbering 1,257 bacterial strains were isolated from 1,066 patients.Strain number of the top 10 species accounted for 70.09％.Gram-positive cocci accounted for 48.93％ and Gram-negative bacilli for 49.72％.Among Staphylococcus aureus and epidermidis,methicillin-resistant bacterial strains accounted for 34.76％ and 71.08％ respectively,but none were resistant to vancomycin or linezolid.Enterococcus faecalis contained 6.06％ vancomycin-resistant enterococcal (VRE) and remained ＞ 90％ sensitive to teicoplanin,ampicilin and vancomycin.Enterococcus faecium contained 10.53％ VRE and remained ＞90％ sensitive to teicoplanin and ＞ 80％ sensitive to vancomycin.Baumanii contained 12.77％ multidrug resistant strains and remained ＞ 70％ sensitive to imipenem and meropenem.Baumanii/calcoaceticus complex contained 29.72％ multi-drug resistant strains and remained ＞ 50％ sensitive to imipenem and meropenem.Pseudomonas aeruginosa contained 3.73％ multi-drug resistant strains and remained ＞90％ sensitive to amikacin,meropenem,imipenem and piperacillin/tazobactam.No E.coli,klebsiella pneumoniae and enterobacter cloacae resistant to imipenem or meropenem were found.E.coli contained 69.51％ extended-spectrum β-lactamases (ESBLs)-producing strains and remained ＞ 90％ sensitive to piperacillin/tazobactam and ＞ 80％ sensitive to amikacin.Klebsiella pneumoniae contained 53.13％ ESBLs-producing strains and remained ＞ 80％ sensitive to amikacin.Conclusions Common bacteria are the leading cause of posttraumatic infection.Enterococcus faecalis and enterococcus faecium demonstrate higher susceptibility to teicoplanin; two kinds of acinetobacter demonstrate higher susceptibility to imipenem.

目的 了解近年烧伤患者创面病原菌分布特点及耐药情况. 方法 选择2006年1月-2011年12月笔者单位烧伤科559例患者1422份创面分泌物标本,共分离出病原菌1246株.应用全自动微生物鉴定药敏仪及配套试剂进行菌种鉴定和药物敏感试验.采用EpiCenter微生物管理软件,统计分析各年度烧伤创面病原菌分布情况及主要革兰阴性杆菌、革兰阳性球菌对抗生素的敏感率变化情况. 结果 1246株病原菌中,革兰阴性杆菌696株占55.86％,革兰阳性球菌530株占42.54％.金黄色葡萄球菌检出率最高,共249株占19.98％,其次为铜绿假单胞菌152株占12.20％.6年间,金黄色葡萄球菌检出率较稳定,铜绿假单胞菌检出率呈上升趋势.检出的金黄色葡萄球菌和表皮葡萄球菌中,甲氧西林耐药金黄色葡萄球菌和甲氧西林耐药表皮葡萄球菌分别占63.45％(158/249)和75.00％ (54/72).未检出万古霉素、利奈唑胺耐药金黄色葡萄球菌和表皮葡萄球菌.检出的粪肠球菌和屎肠球菌中,万古霉素耐药率分别为5.19％和12.90％.检出的铜绿假单胞菌对阿米卡星、美罗培南及哌拉西林/他唑巴坦敏感率大于60.00％.检出的鲍氏不动杆菌、鲍氏醋酸钙复合不动杆菌对10种常见抗生素的敏感率为2.50％ ～ 40.00％.检出的肠杆菌科细菌,主要包括大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌,3种细菌对亚胺培南、美罗培南敏感率均为100.00％.产超广谱β内酰胺酶(ESBL)大肠埃希菌检出率为59.78％ (55/92),对阿米卡星与哌拉西林/他唑巴坦敏感率大于80.00％;产ESBL肺炎克雷伯菌的检出率为50.00％(27/54),对左氧氟沙星与阿米卡星敏感率大于60.00％;阴沟肠杆菌对阿米卡星敏感率大于80.00％. 结论 笔者单位烧伤科2006-2011年烧伤创面病原菌中,居前5位的依次为金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、鲍氏醋酸钙复合不动杆菌、鲍氏不动杆菌,其中后2种细菌对所有抗生素的敏感率极低.