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目的探讨失代偿期肝硬化患者医院感染的危险因素,以控制和预防感染的发生,改善患者预后。方法回顾性分析150例失代偿期肝硬化住院患者临床资料,总结医院感染相关危险因素,采用SPSS13.0软件进行数据分析,将患者年龄、性别、肝功能分级、血清白蛋白、白细胞计数、有无侵入性操作史、有无抗病毒治疗、住院时间作为自变量,是否并发感染为因变量,进行单因素logistic回归分析。结果 150例患者发生医院感染32例,感染率21.3%,失代偿期肝硬化患者医院感染主要类型有呼吸道感染、自发性细菌性腹膜炎;细菌培养共分离病原菌24株,主要病原菌依次为大肠埃希菌、肺炎克雷伯菌、肺炎链球菌、白色假丝酵母菌;感染患者多有肝功能分级高、白细胞计数低、低蛋白血症、侵入性操作史、住院时间长、未进行彻底抗病毒治疗等危险因素;多因素回归分析显示,肝功能分级、抗病毒治疗、侵入性操作及住院时间是影响失代偿期肝硬化患者医院感染的独立危险因素(P<0.05)。结论失代偿期肝硬化患者医院感染与多种因素相关,在患者治疗过程中应引起重视,以预防和减少感染的发生。
Objective To investigate the risk factors of nosocomial infection in patients with decompensated cirrhosis and to control and prevent the occurrence of infection and improve the prognosis of patients. Methods The clinical data of 150 hospitalized patients with decompensated cirrhosis were retrospectively analyzed. The risk factors of nosocomial infection were summarized. The data were analyzed by SPSS 13.0 software. The patients’ age, gender, grade of liver function, serum albumin, white blood cell count, With or without invasive operation history, with or without antiviral therapy, hospitalization time as an independent variable, whether concurrent infection as a dependent variable, univariate logistic regression analysis. Results There were 32 cases of nosocomial infection and 21.3% infection in 150 cases. The main types of nosocomial infection in patients with decompensated cirrhosis were respiratory tract infection and spontaneous bacterial peritonitis. 24 strains of pathogens were isolated from the bacterial culture. The main pathogenic bacteria were colorectal Corynebacterium, Klebsiella pneumoniae, Streptococcus pneumoniae, Candida albicans; Infection in patients with multiple liver function grading, low white blood cell count, hypoproteinemia, history of invasive procedures, hospitalization for a long time, did not conduct a thorough anti- Risk factors such as virus therapy. Multivariate regression analysis showed that liver function grading, antiviral therapy, invasive operation and hospital stay were independent risk factors for nosocomial infection in patients with decompensated cirrhosis (P <0.05). Conclusions NOS in patients with decompensated cirrhosis is related to many factors and should be paid more attention in the course of treatment to prevent and reduce the occurrence of infection.