肝硬化上消化道出血合并细菌感染的临床研究

Clinic study on bacterial infection in cirrhotic patients with gastrointestinal bleeding

目的 了解肝硬化上消化道出血合并细菌感染对再出血率及 4周病死率的影响。方法 观察 70例入院前 1周未使用抗菌药物的肝硬化上消化道出血患者 ,分别于入院后 1、2、3、5与 7天进行血液、尿液、腹水细菌培养 ,采用Child积分评价肝功能损害程度。结果 2 0例 (2 8 6% )在入院 7天内发生 3 6例次细菌感染 ,感染组Child积分明显高于非感染组 (P <0 .0 1) ,再出血发生率 (5 0 %比 10 % ;P <0 .0 1) ,4周病死率 (3 5 %比 13 .3 % ;P <0 .0 1)明显上升。结论 肝硬化患者发生细菌感染时会明显增加肝脏损害程度 ,并可能增加近期死亡率 。

Objective To determine the incidence of bacterialinfections in cirrhotic patients with gastrointestinal bleeding and the influence of infectionson on the risk of rebleeding and death. Methods 70 Cirrhotic patients admitted for gastrointestinal bleeding who had not received antibacterialtreatment in the previous 7 days were included .Blood ,urine ,and ascitic fluidcultures were systematically performed 1,2,3,5 and 7 days after admission. Results Thirty-six infectionswere documented in 20 patients (28.6%)within 7 days of admission.In patients with bacterial infection ,mean Child -pugh score was significantly higher; early rebleeding was more frequent(50%vs 10%; P <0.01),and 4 week mortality rate was higher (35% vs 13.3%; P <0.01).Conclusion Companecl with pati ents without batenal infection.