老年肝硬化患者合并医院感染危险因素分析

Risk Factors Analysis of Liver Cirrhosis Combined with Hospital Infection in Elderly Patients

目的探讨老年肝硬化患者合并医院感染的相关因素,为该类患者的治疗与预防工作提供理论依据。方法回顾性分析我院2009年1月至2013年12月收治的200例老年肝硬化患者的临床资料,探讨老年肝硬化患者合并医院感染的相关因素。结果 200例患者中,医院感染发生率为21.5%(43/200),病原菌检出率为81.4%(35/43)。>65岁的患者医院感染率高于<65岁患者;住院时间>20 d的患者医院感染率高于住院时间<20 d的患者;白蛋白<3.0 g/dl的患者医院感染率高于白蛋白≥3.0 g/dl的患者;有侵袭性操作、并发症、应用抗生素的患者医院感染率高于无侵袭性操作、无并发症、未用抗生素的患者;Child-Pugh分级越高的患者,医院感染率越高,所有差异均具有统计学意义(P<0.05)。结论老年肝硬化患者易发生医院感染,病原菌以革兰阳性菌为主。患者合并医院感染的危险因素众多,临床工作人员应行对因治疗,并制定相应预防措施,以降低医院感染发生率。

Objective To study the relevant factors of elderly cirrhosis patients combined with hospital infection, and provide theoretical basis for the treatment and prevention of such patients. Methods The clinical data of 200 elderly patients with liver cirrhosis treated in our hospital from January 2009 to December 2013 were retrospectively analyzed, the relevant factors of elderly cirrhosis combined with hospital infection were investigated. Results The rate of hospital infection was 21.5%（43/200） and the detection rate of pathogen was81.4%（35/43） among 200 patients. The hospital infection rate of patients over 65 was higher than that of patients under 65; the hospital infection rate of patients whose hospital stays 20 d was higher than that of patients whose hospital stays 20 d; the hospital infection rate of patients whose albumin 3.0 g/dl was higher than that of patients whose albumin ≥3.0 g/dl; the hospital infection rate of patients with invasive operation, complications and antibiotic was higher than that of patients without invasive operation, complications and antibiotic; the higher the Child-Pugh classification, the higher the hospital infection rate, all the difference was statistical（P 0.05）. Conclusions Elderly patients with cirrhosis are prone to hospital infection, Gram-positive bacteria was chief pathogenic bacteria. The risk factors are numerous,clinical staff should conduct etiological treatment and formulate relevant preventive measures to reduce the hospital infection rate.