乙肝肝硬化失代偿期患者合并医院感染的临床调查

目的分析乙肝肝硬化失代偿期患者合并医院感染的情况并提出相应措施。方法回顾性分析武汉科技大学附属汉阳医院2011年3月-2012年3月收治的262例乙肝肝硬化住院患者发生医院感染的情况。结果 262例患者中发生医院感染者49例(18.7%);易感部位主要是腹膜、呼吸道、肠道及泌尿道;发生医院感染的时间为(20.1±0.7)d;病原学标本检查:主要是大肠埃希菌,其次是肺炎克雷伯菌以及白色念珠菌等。导致乙肝肝硬化失代偿期患者出现医院感染的相关因素主要是:年龄≥60岁,Child-Pugh分级C级,有并发症,有侵入性操作史,住院时间≥15 d,采用2种或以上的抗生素。结论合理使用抗生素,尽量减少入侵性操作等帮助乙肝肝硬化失代偿期患者提高其机体的免疫抵抗力,降低医院感染的发生率。

Clinical survey and preventive measures on patients with decompensate cirrhosis and nosocomial infection

Objective To analyze the case of hepatitis B cirrhosis patients with decompensated merger hospital infections and propose appropriate countermeasures.Methods A total of 262 cases of hepatitis B cirrhosis with nosocomial infection in the Affiliated Hospital of Wuhan Hanyang University of Science and Technology from Mar.2011 to Mar.2012 and related factors were investigated.Results Forty-nine cases （18.7％） occurred nosocomial infection in 262 cases.Susceptible parts were mainly peritoneum,respiratory,intestinal and urinary tract.Nosocomial infection time was （20.1 ± 0.7） days.Etiology specimen examination：mainly Escherichia coli,followed by Klebsiella pneumoniae and Candida albicans.HBV-related factors leading to cirrhosis of hospital infection in patients with decompensated mainly were：age ≥60 years,child-pugh class C classifications,complications,invasive procedures,hospital ≥ 15 days,using two kinds of antibiotics or more antibiotics.Conclusion Rational use of antibiotics to minimize invasive operation to help patients with decompensated liver cirrhosis improve their immune resistance,reduce the incidence of nosocomial infections.