慢性重型乙型病毒性肝炎患者医院感染特点及相关危险因素分析

Risk Factors and Infection Characteristics in Patients with Chronic Severe Hepatitis B

目的分析慢性重型乙型病毒性肝炎患者医院感染特点和相关危险因素及预防措施。方法采用回顾性调查方法，对2006年1—12月354例慢性重型乙型病毒性肝炎住院患者医院感染的发病率、发病诱因、病原菌分布、感染部位等进行调查分析。结果医院感染率为16．67％，感染时间多发生在住院15～30d（47．46％）；感染部位以腹腔感染为主（40．32％），其次为下呼吸道（22．58％）；病原菌以革兰阴性杆菌为主（68．75％）；导致感染的危险因素为侵人性操作、低蛋白血症、内毒素血症、高龄患者、使用抗菌药物、细胞免疫功能低下等。结论临床要加强慢性重型乙型病毒性肝炎患者医院感染相关危险因素的控制，有效预防医院感染。

OBJECTIVE To analyze the characteristics of nosocomial infections, risk factors and prevention measures in patients with chronic severe hepatitis B. METHODS A retrospective review of the medical records of 354 patients with chronic severe hepatitis B admitted between Jan 2006 and Dee 2006 was performed. RESULTS The incidence of nosocomial infection in patients with chronic severe hepatitis B was 16.67% and mainly infection sites consisted of abdominal cavity （40.32 % ）, and upper respiratory tract （22.58 % ）. The most common infection （47.46%） was occurred during the period of hospitalization 15-30 days after and the most commonly pathogens were Gram-negative bacilli （68. 75%）. The infection risk factors were associated with invasive operation, hypoalbuminemia, endotoxemia, advanced age, antibiotics application and decrease in cell immune function. CONCLUSIONS It is important for the patients with chronic severe hepatitis B to strengthen management on related risk factors in order to prevent nosocomial infection effectively.