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目的探讨重型病毒性肝炎医院感染中抗菌药物的预防性应用。方法总结分析2004年3月至2008年7月预防性抗菌治疗重型病毒性肝炎住院患者21例,并与未预防性治疗组(对照组)21例对比。结果观察组医院感染率47.6%较对照组71.4%显著降低(P<0.05);重型肝炎首发医院感染的平均时间观察组(10.26±6.71)d较对照组(18.34±9.60)d显著推迟;在肝功能总胆红素、谷丙转氨酶、白蛋白恢复情况观察组较对照组对比,观察组肝功能恢复正常时间较对照组缩短;早、晚期慢性重型肝炎预防性应用抗菌药物对病死率无明显影响,中期慢性重型肝炎的病死率观察组(23.8%)较对照组(47.6%)降低。结论重型病毒性肝炎预防性使用第3代头孢菌素,具有抗菌作用强、毒副作用小的特点,可推迟医院感染的发生时间、降低发生率,肝功能恢复快,对改善重型肝炎的预后亦可能有积极影响。
Objective To investigate the prophylactic use of antibacterials in nosocomial infections of severe viral hepatitis. Methods A total of 21 inpatients with preventative antibacterial treatment of severe viral hepatitis from March 2004 to July 2008 were analyzed and compared with 21 non-prophylactic treatment group (control group). Results The hospital infection rate in the observation group was significantly lower than that in the control group (47.6% vs 71.4%, P <0.05). In the mean duration of first hospital infection of severe hepatitis (10.26 ± 6.71) d was significantly delayed than that of the control group (18.34 ± 9.60) days. Liver function of total bilirubin, alanine aminotransferase, albumin recovery observation group compared with the control group, observation group liver function returned to normal than the control group shortened; early and late chronic severe hepatitis prophylactic use of antibiotics on the mortality was not significantly In the medium term, the mortality of patients with chronic severe hepatitis (23.8%) was lower than that of the control group (47.6%). Conclusions The prophylactic use of the third generation cephalosporins in patients with severe viral hepatitis has the characteristics of strong antibacterial activity and small toxic and side effects, which can delay the occurrence of nosocomial infections, reduce the incidence and speed up the recovery of hepatic function and improve the prognosis of severe hepatitis There may be positive effects.