重型病毒性肝炎患者医院感染及其预防

Nosocomial Infection in Patients with Severe Viral Hepatitis:Status and Prevention

目的探讨重型病毒性肝炎(重肝)医院感染的发生状况,加强医院感染控制。方法对106例重肝病例资料进行了回顾性调查。结果重肝医院感染总发生率为67.9%,随住院时间延长感染率明显增加(P<0.05);感染常见部位依次为腹腔(34.72%)、下呼吸道(23.61%)及肠道(13.89%);致病菌以革兰阴性菌为主(85.29%);随病情进展,其感染率明显升高(P<0.001),且死亡组明显高于生存组(P<0.05),而与临床分型差异无明显性(P>0.05)。结论重肝医院感染率较高,与病情及预后有明显关系,加强支持疗法、减少侵袭性检查、合理用药等措施可降低其感染率。

OBJECTIVE To investigate the status of nosocomial infection in patients with severe viral hepatitis and enhance its nosocomial infection control. METHODS Retrospective study was used in 106 patients with severe viral hepatitis. RESULTS The total nosocomial infection rate was 67.9%. Its infection rate was increased obviously with length of stay elongation (P<0.05). Nosocomial infection occurred frequently in abdominal cavity ((34.72%)), lower respiratory tract (23.61%) and intestinal tract (13.89%) in turn. The main pathogenic (bacteria) were Gram-negatives (85.29%). The infection rate was significant higher in advanced stage than that in earlier and medium stage (P<0.001), and much higher in death group than that in survival one (P<0.05), but no significant difference in encephalopathy type, ascites type and mixed type (P>0.05). CONCLUSIONS The nosocomial infection rate in patients with severe viral hepatitis is high, which is related with its severity and (prognosis.) Supportive treatment, reducing invasive check and rational medical therapy are useful to decrease its nosocomial infection rate.