肝硬化患者医院感染的相关因素分析及治疗策略

Related factors for nosocomial infections in liver cirrhosis patients and treatment strategies

目的探讨肝硬化患者医院感染的相关因素,并总结治疗策略,对其临床预防与治疗提供指导。方法回顾性分析2012年1-12月在医院接受治疗的68例肝硬化患者的临床资料,分析肝硬化患者医院感染的相关因素,并总结治疗对策。结果 68例肝硬化患者中发生感染15例,医院感染率22.1%;感染类型以腹水感染、下呼吸道感染、泌尿系感染为主,分别占33.3%、20.0%、20.0%;15例感染患者中检出病原菌12株,检出率80.0%,其中革兰阳性菌占75.0%,革兰阴性菌占16.7%,真菌占8.3%,患者年龄、肝功能状态、住院时间、侵入性操作、抗菌药物使用与肝硬化患者医院感染的发生密切关系(P<0.05)。结论医院肝硬化患者感染率较高,导致感染发生的危险因素众多,应根据危险因素制定相应的干预措施,以预防及控制肝硬化患者医院感染的发生。

OBJECTIVE To investigate the related factors of hospital infections in patients with liver cirrhosis and summary of treatment strategies,providing guidance to the clinical prevention and treatment.METHODS The clinical data of 68patients with liver cirrhosis treated in the hospital from Jan.2012 to Dec.2012were selected,then the related factors for nosocomial infections in patients with cirrhosis were analyzed,and the treatment countermeasures were summarized.RESULTS There were 15cases of infections in 68patients with liver cirrhosis,and hospital infection rate was 22.1%.The top three types of infection were intra-abdominal infections,lower respiratory tract infections,urinary tract infections,accounting for 33.3%,20.0%,20.0%,respectively;a total of 12 strains of pathogenic bacteria were detected from the 15patients with hospital infections,accounting for 80.0%, among which the gram-negative bacteria accounted for 75.0% and 16.7% of gram-positive bacteria,fungi accounted for 8.3%.Patients′age,liver function status,duration of hospitalization,invasive procedures,antibiotic use in patients with cirrhosis were closely related to the nosocomial infections（P0.05）.CONCLUSION The incidence of nosocomial infections is high in the liver cirrhosis patients,there are a variety of risk factors for the nosocomial infections;corresponding intervention measures should be developed based on the risk factors so as to control the nosocomial infections in the liver cirrhosis patients.