失代偿期肝硬化患者感染的相关因素分析

目的 观察并分析失代偿期肝硬化患者感染的因素,有助于临床预防与治疗.方法 收集医院2006年6月-2011年8月人院治疗的失代偿期肝硬化并发感染患者110例,分析感染相关因素的特点.结果 失代偿期肝硬化并发感染患者以院内感染为主,占69.1％,34例为院外感染,占30.9％,两者的差异有统计学意义(P＜0.01)；感染部位主要为腹膜腔、肺部、胆道,分别占30.0％、25.5％、14.5％,差异有统计学意义(P＜0.01)；110例感染患者共分离出137株病原菌,91例为单种病原菌感染,19例为≥2种的病原菌混合感染,革兰阴性菌62株占45.3％,革兰阳性菌68株占49.6％,真菌7株占5.1％；110例感染患者,存活98例(90.1％)作为存活组,死亡12例(10.9％)作为死亡组；女性、高龄(≥60岁)以及感染菌种数失代偿期肝硬化并发感染患者的死亡率较高(P＜0.05).结论 抗菌治疗与失代偿期肝硬化并发感染患者转归呈正相关关系,≥2种感染与失代偿期肝硬化并发感染患者转归呈负相关关系.

Related factors for infections in patients with decompensated cirrhosis

OBJECTIVE To study and analyze the related factors for the infections in patients with decompensated cirrhosis so as to help the clinical prevention and treatment.METHODS From Jun 2006 to Aug 2011,totally 110 patients with decompensated liver cirrhosis complicated by infections were enrolled in the study,the related factors for the infections were analyzed.RESULTS Decompensated cirrhosis patients were mainly with nosocomial infections,accounting for 69.1%,34 cases were outer-hospital infections,accounting for 30.9%,the difference was statistically significant(P<0.01).The main infections sites were peritoneal cavity,lungs,and biliary tract,accounting for 30.0%,25.5%,and 14.5%,respectively,the difference was statistically significant(P<0.01);totally 137 strains of pathogens were isolated from 110 patients among which 91 patients were with single species of pathogen infection and 19 cases were with mixed infections by two or more pathogens,there were 62(45.3%) strains of gram-negative bacteria,68(49.6%) strains of gram-positive bacteria,and 7(5.1%) strains of fungi;of 110 patients with infections investigated,98(90.1%) patients survived and 12(10.9%) died;the mortality rate was relatively high in the elderly female patients with 60 years of age or older and the decompensated cirrhosis patients complicated with infections(P<0.05).CONCLUSION The antimicrobial treatment has a positive correlation with the outcomes of the decompensated liver cirrhosis patients complicated by infections,while the two or more than two infections has a negative correlation.