肝硬化合并医院感染的相关因素及护理对策

The factors and nursing countermeasures of hepatocirrhosis with hospital infection

目的：探讨肝硬化合并医院感染的的相关因素及护理对策。方法：选择2007年6月～2011年6月肝硬化合并医院感染的患者80例作为观察组，选择肝硬化患者未合并医院感染的80例作为对照组，对两组可能引起医院感染有关的因素进行比较。结果：80例医院感染包括自发性细菌性腹膜炎26例，呼吸系统感染22例，消化系统感染22例，其他10例；症状、体征或腹水检验多不典型，常表现为乏力、纳差加重、低热、黄疽加深、腹水增加等。观察组年龄大、Child—Pugh分级差、侵袭性操作及并存症多、预防应用抗生素比例高、住院时间长等均为医院感染因素，与对照组比较，差异均有统计学意义（均P〈0．05）。结论：肝硬化并发医院感染肝硬化合并医院感染发生率高，护理中应密切观察病情；积极治疗基础疾病；对老年患者实施营养支持；尽量避免或减少不必要的侵袭性诊疗操作，严格执行无菌操作，合理使用抗生素，尽量缩短住院时间。

Objective： To explore the factors and nursing countermeasures of hepatocirrhosis with hospital infection. Methods： 80 patients with hepatocirrhosis with hospital infection were selected as observation group from June 2007 to June 2011. 80 patients with hepatocirrhosis unincorporated of hospital infection were selected as control group; the hospital infection factors of two groups were compared. Results： 80 cases of hospital infection included 26 cases with spontaneous bacterial peritonitis, 22 cases with respiratory infections, 22 cases with digestive system infection, the other were 10 cases. Symptoms, signs or ascites inspection of patients were not more typical, usually presented as weak, feeding aggravating, low heat, jaundice deepen, ascites increase and so on. The hospital infection factors of observation group were elder, poor Child-Pugh grading, aggressive operation and more coexist disease, the high proportion of preventing and applying in an- tibiotic, a long time of hospitalization, there were significant differences compared with the control group （all P〈0.05）. Conclusion： Hepatocirrhosis with hospital infection has high incidence, the patient＇s condition in nursing should be closely observed during the care with treating basic diseases positive and the implementation of nutrition support to elderly pa- tients. We should try to avoid or reduce unnecessary aggressive medical operation, strictly implement sterile operation, rea- sonable use of antibiotics and try to shorten the time of hospitalization.