重症肝炎和肝硬化并发医院感染临床分析

Clinical analysis of severe hepatitis and cirrhosis complicated with hospital infection

目的:探讨导致肝硬化和重症肝炎并发医院感染的因素,为防治医院感染提供参考。方法:收集2008年3月～2009年3月248例收住我院的重症肝炎和肝硬化患者,记录其发生医院感染的情况,进行回顾性调查。结果:248例患者中,89例发生医院感染,感染率为35.9%,恶化或死亡的医院感染率(17.5%)高于好转或痊愈组(11.6%)(P<0.05)。并发医院感染的多少与患者的年龄有密切关系。腹腔感染占院内感染的首位,致病菌中革兰阴性菌占的比例最高;发生感染的因素主要有免疫抑制剂的使用、广谱抗生素的使用、侵入性诊疗以及同时患有其他疾病等。结论:重症肝炎及肝硬化患者易发生医院感染,发生院内感染的患者一般都会发生病情恶化,预后差,医护人员应该努力找到发生感染的原因,尽最大努力降低感染率。

Objective：To investigate the causes of cirrhosis and severe hepatitis complicated with hospital infection,and providing a reference for the prevention of hospital infection.Methods：Collecting 248 cases of patients with severe hepatitis and cirrhosis in our hospital from March 2008 to March 2009,Recorded the case of the hospital infection and carried out a retrospective analysis.Results：Among 248 cases of patients,89 cases had hospital infection,the rate of infection was 35.9%;the rate（17.5%） of the deterioration or death group was higher than the proved or cured group（11.6%）（P0.05）.The number of hospital infection was closely related with the age of the patients.Abdominal infection was the most of hospital infections;gram-negative bacteria took up the highest proportion of pathogens;the main factors of the infection included the use of immunosuppressive agents and broad-spectrum antibiotic,invasive therapies,and with other diseases at the same time.Conclusion：Severe hepatitis and cirrhosis patients are likely to complicate hospital infection.Patients with hospital infection usually occurs disease progression and poor prognosis,medical personnel should strive to find the causes of infections and make the greatest efforts to reduce the rate of infection.