【摘要】 目的探讨乙型肝炎肝硬化合并上消化道出血患者医院感染的相关因素,为预防和控制乙型肝炎肝硬化合并上消化道出血患者发生医院感染提供依据。方法回顾性分析医院2010年1月-2012年10月867例住院乙型肝炎肝硬化合并上消化道出血患者临床资料,采用SPSS 13.5统计软件,对医院感染率的相关因素进行统计分析。结果调查867例患者中发生医院感染253例,感染率为29.18%;感染部位主要为腹腔和呼吸道,分别占28.85%和29.25%;共检出病原菌103株,阳性率为40.71%,检出的病原菌以革兰阴性菌为主,占71.84%,检出的主要病原菌对抗菌药物的敏感率普遍较低;乙型肝炎肝硬化合并上消化道出血患者发生医院感染与HBVDNA病毒载量、出血多少、三腔两囊管的使用、预防性应用抗菌药物、Child-pugh评分、腹水、血清白蛋白等因素相关。结论乙型肝炎肝硬化合并上消化道出血患者应预防性使用抗菌药物治疗,积极抗病毒治疗,加强保肝、利尿、支持治疗,采取套扎止血等可以降低医院感染的发生。更多还原

【Abstract】 OBJECTIVE To explore the correlative factors causing nosocomial infections to patients in hepatitis B liver cirrhosis with gastrointestinal haemorrhage,so as to provide scientific basis for the prevention and control of the nosocomial infections.METHODS A retrospective analysis was implemented on 867inpatients suffered from hepatitis B liver cirrhosis with gastrointestinal haemorrhage from Jan 2010to Oct 2012.The correlative factors causing incidence of hospital infection were analyzed by SPSS 13.5software.RESULTS Among 867patients,253 patients suffered from nosocomial infections with a rate of 29.18%;the respiratory tract and the abdominal infections were the main infection positions,accounting for 29.25% and 28.85% respectively.Totally 103strains of pathogens were isolated,the positive rate was 40.71%.Gram-negative bacteria were dominated,accounting for 71.84%.The gram negative bacteria were the main pathogenic bacteria,and their drug susceptivity rate was relatively low to commonly used antibiotics in general.Nosocomial infections among patients suffered from hepatitis B liver cirrhosis with gastrointestinal haemorrhage were related to the risk factors including HBV-DNA viral load,haemorrhage,using of three-chamber and two balloon catheters,preventative antibiotics compression,child-pugh score,ascites,serum albumin and so on.CONCLUSION Patients suffering from hepatitis B liver cirrhosis with gastrointestinal haemorrhage can reduce the incidence of nosocomial infections by the following ways such as taking antibacterial agents preventatively,actively employ antiviral therapy,and strengthen the treatment for liver protection,dieresis and other supportive treatments as well as hemostasis with ligation.更多还原