老年肝病患者医院感染特点及相关危险因素的研究

目的探讨老年肝病患者医院感染特点及相关危险因素. 方法对1995年1月～2003年1月收治的232例老年肝病患者进行临床调查分析. 结果 44例发生医院感染,感染率为18.97%,感染时间多发生在住院的2～20 d(63.64%),其中重症肝炎患者医院感染率最高,其次为肝癌、肝炎后肝硬化;感染部位以呼吸道感染为主(56.8%),其次为腹腔内组织感染(22.2%);导致感染的危险因素依次为侵袭性操作、抗菌药物使用、肝肾综合征、腹水存在等;与非感染对照组相比,医院感染患者并发肝性脑病、肝肾综合征、上消化道出血、电解质紊乱、病死率明显增高. 结论老年肝病患者医院感染发生率高,严重并发症多见,病死率高,临床医务人员应高度重视,采取综合措施加以防治.

Nosocomial Infection and Risk Factors in Aged Patients with Liver Diseases

OBJECTIVE To explore the characteristic of nosocomial infection and the risk factors of liver diseases in aged patients. METHODS The prospective clinical investigations were performed in 232 patients whose ages were more than 60 years old with liver diseases from Jan 1995 to Jan 2003. RESULTS From them 18.97% of patients suffered nosocomial infection and the incident time of infection was mainly in 2 to 20d after admission. The highest of nosocomial infection rate was severe hepatitis, secondly was cancer of the liver and posthepatitic cirrhosis. The location of infections was mainly in respiratory tract (56.8%), the second one was abdominal cavity tissues (22.2%). The factors related to nosocomial infection were improper manipulations, use of broad-spectrum antibiotics, hepatorenal syndrome and electrolytic disturbance. Compared with control group, the patients with nosocomial infection had higher incidence of hepatic coma, hepatorenal syndrome, hemorrhage of upper digestive tract and electrolytic disturbance. CONCLUSIONS The aged patients with liver disease have high incidence of nosocomial infection. The patients with nosocomial infection have high incidence of severe hepatitis-associated complications and high fatality. Clinicians should pay more attention to nosocomical infection in aged patients with liver disease and prevent the incidence of nosocomial infection.