肝硬化合并医院感染的危险因素分析
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摘要
目的探讨肝硬化患者发生医院感染情况及其危险因素。方法收集2015年1月至2016年12月本院收治的268例肝硬化患者临床资料,分析医院感染发生情况及其高危因素。结果 268例肝硬化患者医院感染发生率为20.15%(54/268),以呼吸系统为主要感染部位,占40.74%(22/54),腹腔感染占24.07%(13/54),胃肠道感染14.81%(8/54),泌尿系统感染占12.96%(7/54),皮肤软组织感染占5.56%(3/54),感染部位不明占1.85%(1/54)。高龄、住院时间长、肝功能受损、肝炎后肝硬化、合并并发症、预防性应用抗生素以及侵入性操作是医院感染发生的危险因素(P<0.05)。结论肝硬化患者医院感染发生率较高,引起感染的危险因素较多,应制定相应的干预措施,以减少肝硬化患者医院感染的发生。
Objective To examine the prevalence of and risk factors for nosocomial infection in patients with liver cirrhosis. Methods Clinical data on 268 patients with liver cirrhosis seen at this Hospital from January 2015 to December 2016 were collected, and the prevalence of and risk factors for nosocomial infection were retrospectively analyzed. Results Of 268 patients with liver cirrhosis, 54 developed a nosocomial infection, for a rate of infection of 20.15%. Ninety-eight patients(79.85%) did not develop a nosocomial infection. The main site of infection was the respiratory tract(22 patients, 40.74%), the abdomen(13 patients, 24.07%), the gastrointestinal tract(8 patients, 14.81%), the urinary tract(7 patients, 12.96%), the skin and soft tissue(3 patients, 5.56%), and an unknown site(1 patient, 1.85%). Being older, a longer duration of hospitalization, cirrhosis following hepatitis, diminished liver function, complications, prophylactic use of antibiotics, and undergoing an invasive procedure were risk factors for development of a nosocomial infection(P<0.05). Conclusion Patients with liver cirrhosis have a higher incidence of and more risk factors for nosocomial infections. Corresponding interventions should be devised in accordance with risk factors in order to reduce the incidence of nosocomial infections in patients with liver cirrhosis.
Objective To examine the prevalence of and risk factors for nosocomial infection in patients with liver cirrhosis. Methods Clinical data on 268 patients with liver cirrhosis seen at this Hospital from January 2015 to December 2016 were collected, and the prevalence of and risk factors for nosocomial infection were retrospectively analyzed. Results Of 268 patients with liver cirrhosis, 54 developed a nosocomial infection, for a rate of infection of 20.15%. Ninety-eight patients(79.85%) did not develop a nosocomial infection. The main site of infection was the respiratory tract(22 patients, 40.74%), the abdomen(13 patients, 24.07%), the gastrointestinal tract(8 patients, 14.81%), the urinary tract(7 patients, 12.96%), the skin and soft tissue(3 patients, 5.56%), and an unknown site(1 patient, 1.85%). Being older, a longer duration of hospitalization, cirrhosis following hepatitis, diminished liver function, complications, prophylactic use of antibiotics, and undergoing an invasive procedure were risk factors for development of a nosocomial infection(P<0.05). Conclusion Patients with liver cirrhosis have a higher incidence of and more risk factors for nosocomial infections. Corresponding interventions should be devised in accordance with risk factors in order to reduce the incidence of nosocomial infections in patients with liver cirrhosis.
引文
[1] 吕玉凤.肝硬化患者感染危险因素分析[J].中国医学工程,2014,22(8):113.
[2] 刘云,朱猛,杨红欣.住院肝硬化患者医院感染的危险因素分析[J].中国全科医学,2013,16(1B):198-9.
[3] 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8 (6):324-9.
[4] 中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京:中华人民共和国卫生部,2001:10-12.
[5] 赵丛林,李焱.肝硬化患者发生医院感染的危险因素分析[J].现代预防医学,2013 ,40 (6):1183-4.
[6] Acevedo J. Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies[J]. World J Hepatol, 2015, 7 (7): 916-21.
[7] 郭万越.肝硬化患者并发医院感染临床分析[J].实用肝脏病杂志,2011,14(6):464-5.
[8] 郑链跃,陶爱萍,丁小平,等.肝硬化患者医院感染的相关因素分析及治疗策略[J].中华医院感染学杂志,2014,24(1):130-2.
[9] 练德义.肝硬化患者医院感染相关因素分析[J].山东医药,2010,50(4):76-7.
[10] 汤国红,蒋丹.肝硬化患者医院感染率及危险因素[J].中国感染控制杂志,2015,14(5):329-30.
[11] 王赛,曾亚.肝硬化患者医院肺部感染的临床分析[J].实用预防医学, 2011, 18(7): 1211-3.
[12] 杨红霞,曾维政,张勇,等.乙肝后肝硬化医院感染的临床观察[J].西南国防医药 , 2014, 24(8):864-6.
[13] Vannella KM, Moore BB.Viruses as co-factors for the initiation or exacerbation of lung fibrosis[J].Fibrogenesis Tissue Repair,2008,1(1):2.
[14] 汪鑫,彭春仙,叶程军,等.肝硬化患者医院感染的危险因素分析与预防[J].中华医院感染学杂志,2015,25(1):169-73.
[15] 孙兰芳,陈家焱,曹小萌,等.失代偿期肝硬化患者医院感染的影响因素分析[J].中国综合临床,2012,28(10):1072-5.
[16] 刘俊杰,279 例肝硬化患者医院感染情况调查[J].实用医学杂志,2013,30( 11) : 1017-1018
[2] 刘云,朱猛,杨红欣.住院肝硬化患者医院感染的危险因素分析[J].中国全科医学,2013,16(1B):198-9.
[3] 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8 (6):324-9.
[4] 中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京:中华人民共和国卫生部,2001:10-12.
[5] 赵丛林,李焱.肝硬化患者发生医院感染的危险因素分析[J].现代预防医学,2013 ,40 (6):1183-4.
[6] Acevedo J. Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies[J]. World J Hepatol, 2015, 7 (7): 916-21.
[7] 郭万越.肝硬化患者并发医院感染临床分析[J].实用肝脏病杂志,2011,14(6):464-5.
[8] 郑链跃,陶爱萍,丁小平,等.肝硬化患者医院感染的相关因素分析及治疗策略[J].中华医院感染学杂志,2014,24(1):130-2.
[9] 练德义.肝硬化患者医院感染相关因素分析[J].山东医药,2010,50(4):76-7.
[10] 汤国红,蒋丹.肝硬化患者医院感染率及危险因素[J].中国感染控制杂志,2015,14(5):329-30.
[11] 王赛,曾亚.肝硬化患者医院肺部感染的临床分析[J].实用预防医学, 2011, 18(7): 1211-3.
[12] 杨红霞,曾维政,张勇,等.乙肝后肝硬化医院感染的临床观察[J].西南国防医药 , 2014, 24(8):864-6.
[13] Vannella KM, Moore BB.Viruses as co-factors for the initiation or exacerbation of lung fibrosis[J].Fibrogenesis Tissue Repair,2008,1(1):2.
[14] 汪鑫,彭春仙,叶程军,等.肝硬化患者医院感染的危险因素分析与预防[J].中华医院感染学杂志,2015,25(1):169-73.
[15] 孙兰芳,陈家焱,曹小萌,等.失代偿期肝硬化患者医院感染的影响因素分析[J].中国综合临床,2012,28(10):1072-5.
[16] 刘俊杰,279 例肝硬化患者医院感染情况调查[J].实用医学杂志,2013,30( 11) : 1017-1018