重型肝炎继发医院感染120例临床治疗分析

A Clinical Analysis of Nosocomial Infections in 120 Cases with Severe Viral Hepatitis

目的:分析重型病毒性肝炎患者医院感染的部位、病原及预后。探讨有效的预防和控制措施。方法:回顾性分析281例重型肝炎住院患者的临床资料。对比分析感染与未感染的病死率。结果:本组281例重型病毒性肝炎患者有120例发生医院感染,总感染率为42.7%。其中急性重肝4例,感染率21.1%(4/19),亚急性重肝39例,感染率38.2%(39/102),慢性重肝77例,感染率48.1%(77/160)。腹腔感染占首位,占40.3%,依次是胃肠道、口腔、下呼吸道。120例发生医院感染的患者中,死亡61例,病死率为50.8%。而未发生医院感染的161例患者中,死亡40例,病死率为24.8%。结论:有效的预防和积极的治疗医院感染,对于提高肝炎治愈率、降低死亡率有重要的意义。

Objective：To analyze the sites ,pathogens ,and prognosis of nosocomial infeetions in patients with severe viral hepatitis（ SVH）, and explore the efficient measures to decrease nosocomial infections. Methods ： Two hundred and eighty one hospitalized cases of SVH were investigated and analyzed retrospectively, through comparing fatality rate between the infected group and the taintless group. Results： In 281 cases of SVH,there were 120 cases complicated by infection. The total rate of infection was 42. 7%. In these infected ease,there were 4 patients with acute severe viral hepatitis,39 patients with sub-acute severe viral hepatitis and 77 ones with chronic severe viral hepatitis, with each of the respective infection rate of 21.1% （4/9） ,38.2% （39/102）aud 48. 1% （77/160）. Abdominal cavity infection was the most usual and accounted for 40. 3% ;in addition to it, the infection sites included gastrnintestinal tract, oral cavity and lower respiratory traet in order. In the infected group ,61 patients died with 50. 8 % of mortality, while in 161 case without infection .40 patients died with 24 % of mortality. Conclusion： Date presented indicated that efficient prevention and active treatment with nosocomial infections is vital for increasing of cure rate and decreasing of mortality