摘要
目的探究肝硬化消化道出血患者院内感染的危险因素。方法187例肝硬化消化道出血患者为研究对象,患者确诊疾病后进行对症治疗。收集患者各项临床资料,统计院内感染发生情况及预后情况,分析肝硬化消化道出血患者院内感染的危险因素。结果187例肝硬化消化道出血患者中,发生院内感染39例,院内感染发生率为20.86%,其中腹腔感染15例、上呼吸道感染10例、下呼吸道感染7例、胃肠道感染3例、泌尿系统感染2例、循环系统感染2例。未发生院内感染患者的住院时间、预防性应用抗生素、侵入性操作、腹水、Child-Pugh分级、合并慢性病、凝血酶原时间、血红蛋白、血清白蛋白、出血方式与发生院内感染患者比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,住院时间>14 d、未预防性应用抗生素、有侵入性操作、有腹水、Child-Pugh分级C级、合并慢性病为肝硬化消化道出血患者发生院内感染的独立危险因素(P<0.05)。结论住院时间长、未预防性应用抗生素、侵入性操作、腹水、慢性病以及Child-Pugh分级均是导致肝硬化消化道出血患者发生院内感染的原因,早期识别院内感染高发患者,可降低再出血率与死亡率,改善患者预后情况。
Objective To investigate the risk factors of nosocomial infection in cirrhotic patients with gastrointestinal bleeding.Methods 187 cirrhotic patients with gastrointestinal bleeding were studied,and the patients were treated symptomatically after diagnosis.All clinical data of the patients were collected,and the occurrence and prognosis of nosocomial infection were counted.The risk factors of nosocomial infection in cirrhotic patients with gastrointestinal bleeding were analyzed.Results Among 187 cirrhotic patients with gastrointestinal bleeding,39 cases of nosocomial infection occurred,and the incidence of nosocomial infection was 20.86%,including 15 cases of abdominal infection,10 cases of upper respiratory tract infection,7 cases of lower respiratory tract infection,3 cases of gastrointestinal tract infection,2 cases of urinary system infection,and 2 cases of circulatory system infection.The hospital stay,prophylactic application of antibiotics,invasive operations,ascites,Child-Pugh grading,comorbid chronic diseases,prothrombin time,hemoglobin,serum albumin,and bleeding pattern in patients without nosocomial infection were statistically significant(P<0.05)when compared with patients with nosocomial infection.Multifactorial Logistic regression analysis showed that hospital stay>14 d,absence of prophylactic antibiotics,invasive operations,ascites,Child-Pugh grade C,and comorbid chronic diseases were independent risk factors for nosocomial infections in cirrhotic patients with gastrointestinal bleeding(P<0.05).Conclusion Long hospital stay,absence of prophylactic antibiotics,invasive operations,ascites,chronic disease,and Child-Pugh grading all contribute to the development of nosocomial infections in cirrhotic patients with gastrointestinal bleeding.Early identification of patients with a high incidence of nosocomial infections may reduce rebleeding rates and mortality and improve patient prognosis.
作者
林瑞弟
LIN Rui-di(Dongguan Houjie Hospital,Dongguan 523000,China)
出处
《中国实用医药》
2022年第26期40-43,共4页
China Practical Medicine
关键词
肝硬化
消化道出血
院内感染
危险因素
Cirrhosis
Gastrointestinal bleeding
Nosocomial infection
Risk factors
