肝硬化并发感染患者的临床管理

Clinical management of infections in cirrhosis

感染是肝硬化患者发生肝功能衰竭的主要诱因,导致患者住院时间延长,生活质量下降,病死率增加。近年来,肝硬化患者细菌和多重耐药菌感染的发生率呈上升趋势。对此,早期诊断和快速启用适当的抗菌药物进行经验性治疗至关重要,同时应结合药敏结果及当地细菌耐药情况选用抗菌药物。此外,也应注重宿主免疫功能的调控,维护肠道菌群稳态,积极预防感染以改善患者的预后。

Infection constitutes the major cause of liver failure in patients with cirrhosis.The consequences of infection include prolonged hospitalization,compromised life quality,and increased mortality.Recent years have witnessed an increased prevalence of bacterial and multi-drug resistant bacterial infection in patients with cirrhosis.Therefore,early diagnosis and timely initiate of empiric antimicrobial therapy are of great importance.The choice of antibiotics should consider drug susceptibility results and local drug resistance.In addition,regulation of host immune function,maintenance of intestinal flora homeostasis,and prevention of infection should also be strengthened so as to improve prognosis.