消化道出血患者贫血严重程度与并发院内感染的研究

Study on severity of anemia in patients with gastrointestinal bleeding and nosocomial infection

目的探讨消化道出血贫血程度与院内感染的关系,为消化道出血纠正贫血及防治感染提供策略。方法选取我院2013年1至12月124例年龄≥50岁的消化道出血血红蛋白(Hb)<90 g/L的贫血患者,将其分为感染组(36例)与非感染组(88例),比较两组基础疾病状况、贫血程度、输血量、输血次数、纠正贫血输血持续时间的差异性,数据采用SPSS 17.0软件进行统计分析。结果两组患者糖尿病、肝炎/肝硬化、消化道肿瘤等基础疾病构成比差异具有统计学意义(P<0.05);重度贫血(Hb≤60 g/L)患者院内感染构成比为47.2%(17/36);两组患者贫血程度(χ2=11.693,P=0.003)、输血次数(χ2=12.959,P=0.002)、输血量(χ2=18.615,P=0.000)、抗生素使用时间(χ2=37.192,P=0.000)差异具有统计学意义,而消化道出血纠正贫血不同输血持续时间两组差异无统计学意义(χ2=4.759,P=0.093);两组Hb[(66.39±13.04)g/L vs.(72.81±10.77)g/L]、输血次数(3.08±1.64 vs.2.13±1.63)、抗生素使用时间[(201.60±65.91)h vs.(106.70±89.97)h]差异均具有统计学意义(均P<0.05)。结论消化道出血贫血程度与院内感染相关,其中合并有糖尿病、消化道肿瘤、肝炎/肝硬化等基础疾病者院内感染风险增加,对合并有急慢性消耗性疾病者,积极纠正贫血的同时应规范抗感染治疗,严格控制抗生素使用时间。

Objective To investigate the relationship between the severity of gastrointestinal hemorrhage-induced anemia and nosocomial infection to provide strategies for the correction of anemia and the prevention and treatment of infection caused by gastrointestinal hemorrhage. Methods A total of 124 gastrointestinal hemorrhage-induced anemic patients (aged≥50 years) with Hb<90 g/L at our institution from January to December 2013 were divided into infection (n=36) and non-infection groups (n=88). Differences in underlying conditions, the severity of anemia, the transfusion volume, frequency and time were compared between both groups. SPSS 17.0 software was used for statistical analysis. Results Differences in constituent ratios of diabetes, hepatitis/cirrhosis, and gastrointestinal tumor were statistically significant between both groups (P<0.05). The constituent ratio of nosocomial infection was 47.2% (17/36) in patients with severe anemia (Hb≤60 g/L). Differences in severity of anemia (χ2=11.693, P=0.003), frequency (χ2=12.959, P=0.002) and volume (χ2=18.615, P=0.000) of transfusion, and duration of antibiotic use(χ2=37.192, P=0.000) were statistically significant between both groups (all P<0.05), but not in transfusion at different time points of gastrointestinal hemorrhage (χ2=4.759, P=0.093). There were statistically significant differences in Hb level [(66.39±13.04) g/L vs. (72.81±10.77) g/L], transfusion frequency (3.08±1.64 vs. 2.13±1.63), and duration&nbsp;of antibiotic use [(201.60±65.91) h vs. (106.70±89.97) h] (all P<0.05). Conclusion Gastrointestinal bleeding degree of anemia associated with nosocomial infection, increasing the risk of infections associated with diabetes, digestive tract cancer, hepatitis/cirrhosis and other basic diseases, for patients with acute and chronic wasting disease, we should actively correct anemia and regulate anti infection treatment, strictly control the use of antibiotics.