HIV感染者术后感染并发症风险因素分析

The risk factors analysis of postoperative infectious complications for the patients with HIV/AIDS

目的探讨HIV病人术后发生感染并发症的风险因素及治疗措施。方法对2009年1月至2010年6月上海市公共卫生临床中心外科收治的97例HIV感染手术病人的临床资料做回顾性分析。结果手术前后HIV病人血常规、肝肾功能、CD4、CD8、CD4/CD8差异无统计学意义(P<0.05)。CD4<200个/μL病人(A组,51例)33例发生感染性并发症,2例死于脓毒症;CD4200～350个/μL者(B组,31例)12例发生感染性并发症;CD4>350个/μL者(C组,15例)5例发生感染性并发症。A组的感染并发症发生率显著高于B组和C组(P<0.05)。结论 CD4<200个/μL的HIV病人手术后感染并发症发生风险明显增高,应加强围手术期处理。

Objective To investigate the risk factors of postoperative infectious complications and treatment measure for the patients with HIV/AIDS. Methods The clinical data of 97 HIV-infected patients admitted from Jan 2009 to Jun 2010 in Shanghai Public Health Clinical Center were analyzed retrospectively. Results All patients had peri-operative detection of immune function. The patients were divided into 3 groups according to pre-operative CD4 count： There were 33 cases of infectious complications and two cases died of sepsis in 51 cases of group A （CD4 counts〈200 cell/μL ）; There were 12 cases of infectious complications and there was no death in 31 cases of group B（200 cell/μL≤CD4〈350 cell/μL）; There were 5 cases of infectious complications in 15 cases of group C （CD4≥350 cell/μL）. The infectious complications in group A was significantly higher than those in group B and group C （P〈0.05）. Conclusion The incidence of postoperative infectious complications is significantly higher in the patients of HIV/AIDS with CD4 counts〈 200 cell/p,L. Intensive peri-operative treatment is very important.