肝硬化患者院内获得性肺炎临床分析

Nosocomial Acquired Pneumonia in Cirrhosis:A Clinical Study

目的 为探讨肝硬化患者院内获得性肺炎的特点及耐药情况。方法 分析 12 0例肝硬化患者院内获得性肺炎的临床资料。结果 代偿性肝硬化患者的获得性肺炎发生率为 4 2 % ,失代偿性肝硬化者为 31% ,其主要诱发因素为应用抗生素及免疫调节剂不合理 ;主要病菌为G-杆菌占 78.1% ,其中以大肠埃希菌、铜绿假单胞菌为主 ;真菌感染占 13.4 % ;感染时间多见于入院第 2～ 3周。结论 病原菌对抗生素耐药情况严重 ,治疗应根据药敏试验和临床经验合理选用抗生素。

OBJECTIVE To explore the characteristic and drug resistance of nosocomial pneumonia in the patients with cirrhosis of liver. METHODS A total of 120 cases of nosocomial pneumonia patients with cirrhosis were analyzed. RESULTS The incidence of acquired pneumonia accounted for 43% and 31%, respectively in compensated and decompensated cirrhosis. The main reasons were unreasonable use of antibiotics and immune regulators. The main pathogens were Gram-negative bacteria (78.1%), especially Escherichia coli and Pseudomonas aeruginosa. Infection caused by fungus accounted for 13.4%. The infection period more often occurred in the first 2 to 3 weeks. CONCLUSIONS The drug-resistance of the pathogen is serious. So the selection of antibiotics should be depended on drug susceptibility test and clinical experience of clinician.