重型病毒性肝炎患者肺部感染情况及其危险因素探讨

了解重型病毒性肝炎(重肝)并发肺部感染的情况，并探讨其危险因素。对160例重肝患者合并肺部感染的临床资料进行前瞻性和回顾性研究。160例重肝患者发生肺部感染48例(30．0％)，肺部感染者死亡率为83．3％。14例患者存在两种或两种以上病原菌混合感染，其中以真菌混合其它细菌感染为最常见。重肝患者并发肺部感染与重肝的病期、是否存在严重合并症和并发症、是否有侵袭性操作以及抗生素的应用等有关。如对上述危险因素采取相应的措施，有可能减少肺部感染的发生。

Pulmonary infection and its risk factors in the patients with severe viral hepatitis

To understand the conditions and the risk factors of pulmonary infection in the patients with severe viral hepatitis. Both prospective and retrospective analyses were made on 48 cases suffered from pulmonary infection in 160 cases with severe viral hepatitis. The rate of pulmonary infection in total 160 patients was 30.0% and the mortality was 83.3%. The co-infection with 2 species of bacteria or above was found in 14 patients. Pulmonary infection are closely associated with the later period of hepatic failure. The rate of infection was 54.2% in patients with grave coexisting diseases. There was higher rate of pulmonary infection in patients with hepato-renal syndrome, upper gastrointestinal hemorrhage, hepatic encephalopathy, fungus infection in oral cavity and intestine and invasive operation. The use of antibiotics with more species and longer time is one of important causes of fungus pulmonary infection. Pulmonary infection easily occur in the patients with severe viral hepatitis and is related to the later period of hepatic failure, grave coexisting diseases and complications, invasive operation, species and time of using broad-spectrum antibiotics. It is feasible to prevent pulmonary infection by controlling the above-mentioned risk factors.