摘要
目的探讨肝硬化并上消化道出血患者医院感染的危险因素,为临床防治策略的制定提供参考依据。方法回顾性分析医院2013年1月-2016年1月期间收治的350例肝硬化并上消化道出血患者的临床资料;分析医院感染的发生率、病原菌类型以及感染部位分布情况;通过多因素Logistic回归分析归纳肝硬化并上消化道出血患者发生医院感染的危险因素。结果本研究医院感染的发生率为29.14%,培养出致病菌46株,其中革兰阴性菌24株、占52.17%,革兰阳性菌13株、占28.26%,真菌9株、占19.57%。呼吸道感染最为常见,有40例、占39.22%,其次为腹腔感染31例、占30.39%;多因素logistic分析结果显示,年龄大、血红蛋白水平低、血清蛋白水平低、Child-pugh评分高、未预防性应用抗菌药物、有腹水、未使用三腔两囊管压迫止血以及未使用胃镜套扎止血是肝硬化并上消化道出血医院感染的危险因素(P<0.05)。结论肝硬化并上消化道出血患者医院感染发生率高,临床应加强预防措施,降低患者发生医院感染的风险。
OBJECTIVE To investigate the risk factors of nosocomial infections in patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage,so as to provide theoretical basis for establishment of clinical prevention and treatment strategies.METHODS The clinical data of 350 patients with cirrhosis and upper gastrointestinal hemorrhage admitted from Jan.2013 to Jan.2016 were retrospectively analyzed.The incidence of nosocomial infections,pathogenic bacteria types and infection distribution were analyzed,and the risk factors of nosocomial infections in patients with liver cirrhosis and upper gastrointestinal hemorrhage were analyzed by multivariable logistic regression analysis.RESULTS The incidence of nosocomial infections in this study was 29.14%,and 46 strains of pathogenic bacteria were cultured,including 24 strains of gram-negative bacteria,accounting for 52.17%,13 strains of gram-positive bacteria,accounting for 28.26%,and 9 strains of fungi,accounting for 19.57%.Respiratory tract infection was the most common infections,which were 40 cases,accounting for 39.22%,followed by abdominal infections,which were 31 cases,accounting for 30.39%.Multivariate logistic analysis showed that older age,low levels of hemoglobin,low serum protein levels,low Child-pugh score,unprotected antibiotics,ascites,without three-chamber,two-tube hemostasis and without endoscopic hemostasis were risk factors for nosocomial infections in cirrhosis and upper gastrointestinal hemorrhage（P〈0.05）.CONCLUSION The incidence of nosocomial infections in patients with cirrhosis and upper gastrointestinal hemorrhage is high,clinical measures should be strengthened to reduce the risk of nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第14期3204-3207,共4页
Chinese Journal of Nosocomiology
关键词
肝硬化
上消化道出血
医院感染
危险因素
Liver cirrhosis
Upper gastrointestinal hemorrhage
Nosocomial infection
Risk factors
