重型乙型肝炎患者继发性感染的临床特点

Clinical Behavior of Secondary Bacterial Infection in Patients with Fulminant Hepatitis B

目的研究重型乙型肝炎患者继发性感染的临床特点。方法回顾性分析医院感染内科收治的70例重型乙型肝炎患者继发性感染的临床特点。结果70例患者中发生继发感染者60例(85.7%),其中34例出现2个以上部位感染。较常见的感染部位为腹腔、肺部和胆道,感染率分别为47.1%、35.7%和28.6%,其他感染部位有泌尿道、口腔、上呼吸道、肠道、败血症,感染率分别为8.6%、7.1%、5.7%、2.9%和2.9%,真菌感染12例,占所有感染的17.1%。继发感染患者体温可表现为高热、低热或体温正常,外周血白细胞和中性粒细胞比率可增高或正常。结论重型乙型肝炎患者发生继发性感染比率高,临床表现复杂。

Objective To study the clinical behavior of secondary bacterial infection in patients with fulminant hepatitis B. Methods The clinical data of 70 cases of fulminant hepatitis B with secondary bacterial infection were analyzed retrospectively. Results Sixty cases （85.7 % ） developed bacterial infection in total of 70 cases with fulminant hepatitis B and 34 cases developed bacterial infection in more than 2 sites, The common infection sites were abdominal cavity, lung and biliary tract with infection rates of 47.1%, 35.7 % and 28.6 %, respectively. The other infection sites were urinary tract, buccal cavity, upper respiratory tract, intestines and septicemia with infection rates of 8.6 %, 7.1%, 5.7 %, 2.9 % and 2.9 % respectively. 12 cases （17.1% ） developed fungal infection. Hyperpyrexia, low fever or normal body temperature with high or normal of white blood cell counts and neutrophil cells in peripheral blood were present in the patients with secondary bacterial infection. Conclusions Secondary bacterial infection is present highly in patients with fulminant hepatitis B.