肝功能衰竭继发感染的特点和处理

Clinical characteristics and management of liver failure patients complicated with infection

感染是肝衰竭的常见并发症,其可明显增加病死率.肝衰竭后机体免疫功能障碍、肠道功能改变等因素使得感染发生率高于一般肝病,而激素使用、低白蛋白血症、消化道出血、广谱抗生素使用等是其危险因素.肺部感染、自发性腹膜炎、尿路感染和血流感染是最常见的几种感染类型.为了降低肝衰竭继发感染的病死率,在早期诊治和给予适当预防治疗之外,还要注意抗菌药物滥用和患者与医务人员感染控制教育.

Infection is one of the most frequent complications in liver failure and results in high mortality rates.Patients with liver failure have altered and impaired immunity,which favors bacterial translocation.The most common infections in liver failure are pneumonia,spontaneous bacterial peritonitis （SBP）,urinary tract infections （UTI）,and bloodstream infection.Risk factors associated with the development of infections are variceal bleeding,low ascitic protein level,using of hormones,using of antibiotics,and application of invasive operation,etc.The prognosis of these patients is closely related to a prompt and accurate diagnosis.An appropriate treatment decreases the mortality rates.Preventive strategies are the mainstay of the management of these patients.