重症肝炎并发医院感染的危险因素分析

目的 分析导致重症肝炎患者并发医院感染的危险因素及其特点,为临床预防医院感染提供有利依据.方法 选择医院2008年3月-2010年9月所收治重症肝炎患者208例,将其分成感染组与非感染组,比较两组外周血T细胞亚群的变化,并对其临床资料进行回顾性分析,详细记录其感染情况.结果 208例患者中,46例发生医院感染,感染率为22.12％;感染组与非感染组相比,T淋巴细胞CD3、CD4及CD4/CD8比值出现明显降低,差异有统计学上意义(P＜0.05)；感染组各项并发症的发生率明显高于对照组,差异有统计学意义(P＜0.05);46例患者发生感染的主要部位以腹腔感染居高,占57.89％,其次为呼吸道,占22.81％；致病菌以革兰阴性菌居多,占77.14％；导致重症肝炎并发医院感染的主要因素为抗菌药物的使用、侵入性诊疗操作、肝肾综合症等.结论 重症肝炎并发医院感染的概率较高,并发症较多,发生医院感染患者的病情会发生恶化,且预后较差,临床必须给予高度重视,积极采取措施,找出感染因素,加以预防及治疗,降低感染率.

Risk factors for nosocomial infections in patients with severe hepatitis

OBJECTIVE To analyze the risk factors for nosocomial infections in patients with sever hepatitis so as to provide reliable bases for the clinical prevention of nosocomial infections.METHODS A total of 208 patients with sever hepatitis who enrolled the hospital from Mar 2008 to Sep 2010 were selected and divided into the infection group and the non-infection group,the change of the peripheral blood T cell subsets was compared between the two groups,and the clinical data were retrospectively analyzed,the infection condition was recorded in detail.RESULTS Of 208 patients investigated,nosocomial infections occurred in 46 patients with the infection rate of 22.12%,as compared with the infection group and the non-infection group,the ratio of the T lymphocytes CD3,CD4 and CD4 to CD8 reduced significantly,the difference was statistically significant(P<0.05),the incidence of the complications was significantly higher in the infection group than the control group with statistical significance(P<0.05);the abdominal infections were dominant among the 46 patients,accounting for 57.89%,followed by the respiratory tract infections(22.81%);gram-negative bacteria were the predominant pathogens,accounting for 77.41%;the use of antibiotics,invasive operation,and liver and kidney syndrome were the main risk factors for nosocomial infections in the patients with sever hepatitis.CONCLUSION The incidence of the nosocomial infections in the patients with sever hepatitis is relatively high with many complications,for the patients with nosocomial infections,the condition may deteriorate with a poor prognosis so that the hospital should attach great importance,take effective measures and find out the causes so as to reduce the incidence of nosocomial infections.