肝硬化消化道出血院内感染的影响因素及预防

Influencing factors and prevention of nosocomial infection in liver cirrhotic with gastrointestinal bleeding

目的:分析肝硬化消化道出血院内感染的危险因素及临床意义。方法:回顾性分析2019年4月—2020年4月收治的肝硬化消化道出血患者120例以及同期肝硬化无消化道出血患者120例,分析院内感染的影响因素。结果:肝硬化消化道出血患者院内感染率为21.7%,肝硬化无消化道出血患者院内感染率为6.7%(P<0.05);肝硬化消化道出血患者中,院内感染组与非感染组在白细胞、肝功能分级标准(Child-Pugh)B-C级、使用抗生素情况、主要症状及再出血率方面比较,差异有统计学意义(P<0.05);出血组与未出血组在年龄、白细胞、Child-Pugh B-C级及院内感染率方面比较,差异有统计学意义(P<0.05);抗生素组与非抗生素组白细胞水平及院内感染发生率比较,差异有统计学意义(P<0.05)。结论:肝硬化消化道出血会导致院内感染风险增加,而呕血、白细胞高、Child-Pugh B-C级为院内感染的影响因素,可对此类患者在入院时预防性使用抗生素以降低感染风险。

Objective: To analyze the influencing factors and prevention measures of nosocomial infection in liver cirrhotic with gastrointestinal bleeding.Methods: A total of 240 patients with cirrhosis and gastrointestinal bleeding treated in the hospital from April 2019 to April 2020 and patients with cirrhosis but no gastrointestinal bleeding in the same period were selected.The influencing factors of nosocomial infection were discussed through clinical retrospective analysis.Results: The nosocomial infection rate of cirrhotic patients with gastrointestinal bleeding was 21.7%,and that of cirrhotic patients without gastrointestinal bleeding was 6.7%(P<0.05).There were significant differences in leukocyte, child Pugh B-C grade, antibiotic use and rebleeding rate between nosocomial infection group and non-infection group(P<0.05).There were significant differences in age, leukocyte, child Pugh B-C grade and nosocomial infection rate between bleeding group and non-bleeding group(P<0.05).There were significant differences in leukocyte level and the incidence of nosocomial infection between antibiotic group and non-antibiotic group(P<0.05).Conclusion: Cirrhotic gastrointestinal bleeding can increase the risk of nosocomial infection.Hematemesis, high leukocyte and child Pugh B-C are the influencing factors of nosocomial infection.Antibiotics can be used to reduce the risk of infection in such patients.