慢加急性肝衰竭患者发生肺部感染的现状及影响因素研究

Study on influencing factors of pulmonary infection in patients with hepatitis B virus-related acute-on-chronic liver failure

目的探讨乙型肝炎病毒相关慢加急性肝衰竭(HBV related acute-on-chronic liver failure,HBV-ACLF)患者发生肺部感染的现状及其影响因素。方法回顾性分析2017年1月—2019年12月于上海市某三级甲等医院传染科住院治疗的238例HBV-ACLF患者的病历资料,统计HBV-ACLF患者发生肺部感染的情况,并分析其影响因素。结果238例HBV-ACLF患者,发生肺部感染患者53例,感染率为22.27%;Logistic回归分析显示,高龄、使用激素、长期使用抗生素是HBV-ACLF患者发生肺部感染的独立危险因素。结论HBV-ACLF患者年龄越大、使用激素、长期使用抗生素导致其肺部感染率增高,在HBV-ACLF患者的治疗及护理过程中,应结合发生肺部感染的相关影响因素,采取针对性干预措施,从而降低HBV-ACLF患者的肺部感染率。

Objective To explore the current status and the influencing factors of pulmonary infection in patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods A retrospective analysis was performed for the clinical data of 238 HBV-ACLF patients who were hospitalized in a tertiary hospital in Shanghai from January 2017 to December 2019,so as to analyze the current status and the influencing factors of pulmonary infection.Results Among 238 patients with HBV-ACLF,53 patients suffered from pulmonary infection,and the infection rate was 22.27%.Binary logistic regression demonstrated that age,use of hormones and long-term use of antibiotics were independent risk factors for HBV-ACLF patients complicated with pulmonary infection.Conclusion HBV-ACLF patients with the older age,the use of hormones and the long-term use of antibiotics can increase the risk of pulmonary infection.In the treatment and nursing care process of HBV-ACLF patients,targeted interventions should be taken into consideration of the relevant influencing factors of pulmonary infection,so as to reduce the pulmonary infection rate of HBV-ACLF patients.