肝硬化急性上消化道出血患者医院感染的预防性抗生素应用

目的 探讨预防性抗生素应用对肝硬化并发急性上消化道出血患者治疗及预后的影响.方法 将96例肝硬化并发上消化道出血患者分为预防性抗生素应用组(预防组)和对照组两组.预防组患者入院后除常规治疗外,给予抗生素预防性应用(头孢曲松或氟喹诺酮类);对照组未预防性应用抗生素,统计两组在医院感染率、再出血率、多脏器功能衰竭发生率和病死率的差异.结果 预防组医院感染率18.0%,对照组为41.3%,两组比较差异有统计学意义(P<0.05).医院感染者再出血率为53.6%,高于无感染者的13.2%(P<0.01),表明医院感染与再出血率有关.预防组多脏器功能衰竭发生率22.0%,对照组发生率50.0%(P<0.01).预防组死亡率为16.0%,低于对照组的37.0%(P<0.05).结论 肝硬化并发上消化道出血患者预防性抗生素应用,可降低医院感染发生率和再出血率,提高患者的生存率.

Effect of antibiotic prophylaxis on nosocomial infection in liver cirrhotic patients with acute upper gastrointestinal hemorrhage

Objective To investigate the effect of systemic antibiotic prophylaxis in liver cirrhosis patients with acute upper gastrointestinal hemorrhage. Methods A case-control study was employed. A total of 96 liver cirrhosis patients with upper gastrointestinal hemorrhage were included. The patients who received antibiotic prophylaxis were defined as prophylaxis group(50 patients), the remains defined as control group(46 patients). The incidence of nosocomial infections, rehaemorrhagia, multiple organ failure and mortality were analysed between the two groups. Results The incidence of nosocomial infections in patients from control group was higher than that in patients from prophylaxis group(41.3% : 18.0%, P < 0.05). The rebleeding was more refrequent in patients with nosocomial infections(53.6% : 13.2%, P < 0.01 ). The patients from control group had higher mortality compared with those from prophylaxis group(37.0% : 16.0%, P < 0.05 ). Conclusions In hver cirrhosis patients with upper gastrointestinal hemorrhage, a prophylactic treatment with systemiatic antibiotics is very much effective in preventing nosocomial infections, decreasing rehaemorrhagia and elevating survival rate.