肝移植术后患者医院感染危险因素病例对照研究

Analysis of risk factors for nosocomial infection after liver transplantation:a case-control study

目的探讨肝移植术后患者发生医院感染的危险因素,为制订针对性的预防和控制感染措施提供理论依据。方法采用病例对照研究方法,回顾性调查肝移植术后90例发生医院感染(感染组)及同期124例未发生医院感染(对照组)患者情况,采用单因素及多因素方法筛选出与感染有关的危险因素。结果单因素分析结果显示,性别、术前住院时间、ICU停留时间、气管插管时间、手术次数、腹腔并发症、动静脉插管与术后感染有关(均P<0.05);多因素分析结果显示,性别、术前住院时间>7d、ICU停留时间>2d、合并腹腔并发症、实施动静脉插管是肝移植术后患者感染的独立危险因素(均P<0.05)。结论男性患者、术前住院时间及停留在ICU时间较长、侵入性操作及合并术后腹腔并发症是肝移植术后感染的危险因素。

Objective To explore the risk factors associated with nosocomial infection （NI） after liver transplantation and provide scientific evidence for prevention and control of NI. Method 90 infectious cases and 124 noninfectious cases undergoing liver transplantation involved in the retrospective investigation on risk factors associated infectious complication by logistic regression analysis and case -control study. Results Variables significantly associated with NI in the univariate analysis were sex, hospital stay before transplantations, intensive care unit stay, time for using trachea cannula, frequency of operation, intraabdomial complication, arterial or venous catheterization. In the final logistic regression model, only male, hospitalization stay before liver transplantation longer than seven days, stay in ICU longer than two days, intraabdomial complication, and arterial or venous catheterization were found as independent predictors of NI after liver transplantation. Conclusions Male patient, long stays in ICU and the hospital before transplantation, use of arterial or venous catheterization and intraabdomial complication are main risk factors for nosocomial infection after liver transplantation.