摘要
目的探讨肝衰竭患者医院感染及抗菌药物使用情况,为患者合理用药提供参考依据。方法选取2009-2011年医院收治的180例肝衰竭患者的临床资料,按病情转归将患者分为死亡组130例和存活组50例,对两组患者的医院感染率、抗菌药物的使用情况进行对比分析。结果 180例肝衰竭患者中发生医院感染142例,感染率为78.9%,其中死亡组112例感染率为86.2%,存活组30例感染率为60.0%,两组比较差异有统计学意义(P<0.05);感染部位以腹膜感染为主,占38.2%;其次为呼吸道和胃肠道,分别占19.3%和14.6%;共分离病原菌86株,以大肠埃希菌和肺炎克雷伯菌为主,分别占29.0%、16.3%;180例肝衰竭住院患者均使用了抗菌药物,其中单纯以治疗为目的占61.1%,以预防为目的占12.2%,治疗加预防为目的占26.7%;Ⅰ联用药占23.9%、Ⅱ联占73.9%、Ⅲ联占2.2%,与生存组相比死亡组的抗菌药物联用情况差异有统计学意义(P<0.05)。结论肝衰竭住院患者死亡组患者医院感染率高,以腹膜炎为主,抗菌药物的使用存在一些不合理现象,需进一步改进;临床上应早诊断、早治疗,防止并发症的发生,并根据患者的检查结果,合理使用抗菌药物,避免真菌和耐药菌感染的发生。
OBJECTIVE To investigate the incidence of nosocomial infections in patients with liver failure and observe the status of use of antibiotics so as to provide guidance for reasonable use of antibiotics.METHODS The clinical data were collected from 180patients with liver failure who were treated in the hospital from 2009to 2011, then the patients were divided into the death group with 130cases and the survival group with 50cases according to the outcomes of diseases,the incidence of nosocomial infections and the use of antibiotics were observed and compared between the two groups.RESULTS Of the 180patients with liver failure,the nosocomial infections occurred in 142cases with the infection rate of 78.9%,including 112（86.2%）cases in the death group and 30（60.0%）cases in the survival group,the difference between the two groups was significant（P＆lt;0.05）.The patients with peritoneal infections accounted for 38.2%,the patients with respiratory tract infections 19.3%,the patients with gastrointestinal tract infections 14.6%.A total of 86strains of pathogens have been isolated,among which the Escherichia coli and Klebsiella pneumoniae were dominant,accounting for 29.0%and 16.3%,respectively.All the 180patients with liver failure have used the antibiotics,61.11%of them used simply for treatment, 12.2%for prevention,26.7%for treatment plus prevention.23.9%of the patients took theⅠ drug medication, 73.9%took theⅡ drug medication,and 2.2%took theⅢ drug medication;as compared with the combination use of antibiotics between the death group and the survival group,the difference was significant（P〈0.05）. CONCLUSIONThe incidence of nosocomial infections is high in the hospitalized patients with liver failure in the death group,and the patients with peritoneal infections are dominant.The use of antibiotics is unreasonable and needs to be improved.It is necessary to perform early diagnosis and early treatment,prevent the emergence of complications,and reasonably use antibiotics based on the examination resul
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第9期2140-2142,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(Y2006C02)
关键词
肝衰竭
医院感染
抗菌药物
Liver failure
Nosocomial infection
Antibiotic
