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目的探讨重型肝炎患者院内肺部感染的临床特点和防治对策。方法用回顾性调查方法，调查１９９５年９月～１９９７年８月同一病房住院的重型肝炎患者院内肺部感染的发生率、病死率、深部痰细菌培养结果及肺部感染与其他部位感染、多器官功能衰竭的关系。结果两年内同一病房６８例重型肝炎患者中４０例（５８．８２％）发生院内肺部感染。２５例行深部痰细菌培养者２０例获阳性结果，其中１３例为多种细菌感染。菌种以条件致病菌为主，其中真菌、嗜麦芽假单胞菌、肠球菌、金葡菌较多见，耐药率高。不同时期发生肺部感染者痰菌的主要菌种有所不同。伴有肺部感染者亦常见其他部位感染，特别是原发性腹膜炎、胆道感染、肠道感染、败血症及合并真菌感染较多见，肝性脑病和肝肾综合征的发生率高，治疗效果差，病死率（８２．５％）明显高于无肺部感染的重型肝炎（５３．５７％）。结论重型肝炎患者常见院内肺部感染，病原菌以条件致病菌为主。肺部感染常与其他部位感染和并发症并存，病死率高。预防和治疗院内肺部感染需采取综合措施。
Objective To investigate the clinical characteristics and prevention and treatment of nosocomial pulmonary infection in patients with severe hepatitis. Methods A retrospective survey was conducted to investigate the incidence of nosocomial pulmonary infection, mortality, bacterial culture results of deep sputum and infection of lung and other parts of the patients with severe hepatitis admitted to the same ward from September 1995 to August 1997. The relationship between organ failure. Results Within two years, 40 cases (58.82%) of the 68 patients with severe hepatitis in the same ward had pulmonary infection in the hospital. Twenty cases of 25 cases of deep sputum bacterial culture were positive, of which 13 cases were multiple bacterial infections. Species to opportunistic pathogens, of which fungi, P malophilus, Enterococcus, Staphylococcus aureus more common, high resistance rate. Different stages of sputum bacteria infected with pulmonary infection are different. Patients with pulmonary infection are also common in other parts of the infection, especially in patients with primary peritonitis, biliary tract infections, intestinal infections, sepsis and fungal infections are more common, hepatic encephalopathy and hepatorenal syndrome, the high incidence of treatment Poor, the case fatality rate (82.5%) was significantly higher than the non-pulmonary infection of severe hepatitis (53.57%). Conclusions The common nosocomial pulmonary infection in patients with severe hepatitis is based on the pathogenic bacteria. Pulmonary infection often co-exist with other parts of the infection and complications, high mortality. Prevention and treatment of nosocomial pulmonary infections need to take comprehensive measures.