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目的研究慢性乙型重型肝炎继发感染的临床特点和预后。方法回顾性分析我院感染科收治的98例慢性乙型重型肝炎患者继发感染的临床资料。结果98例病人中发生继发感染者63例,感染率64.3%,其中有15例出现两个部位感染,8例出现两个以上部位感染。较常见的感染部位为腹腔、肺部和肠道,感染率分别为46.0%、31.7%和22.2%。共检出70株病原菌,其中G-杆菌41株,G+球菌22例,真菌7例。非感染患者在重型肝炎的早、中、晚期好转率分别为73.7%、63.6%、40.0%,而继发感染患者在重型肝炎的早、中、晚期好转率分别为52.4%、48.1%、20.0%(P<0.05)。结论慢性乙型重型肝炎患者继发感染率高,临床表现复杂,G-杆菌是其常见病原菌,感染是影响预后的重要因素。
Objective To study the clinical characteristics and prognosis of secondary infection of chronic severe hepatitis B Methods A retrospective analysis of 98 cases of chronic hepatitis B patients admitted to our hospital infected with clinical data of secondary infection. Results There were 63 cases of secondary infection in 98 patients, the infection rate was 64.3%, of which 15 cases had two sites infection and 8 cases had more than two sites infection. The more common sites of infection were abdominal cavity, lungs and intestine, with infection rates of 46.0%, 31.7% and 22.2%, respectively. A total of 70 strains of pathogens were detected, of which 41 were G-bacteria, 22 were G-bacteria and 7 were fungi. The rates of early, middle and late improvement in non-infected patients were 73.7%, 63.6% and 40.0% respectively in severe hepatitis, while those in secondary infection were 52.4%, 48.1% and 20.0% respectively in early, middle and late stages of severe hepatitis % (P <0.05). Conclusion Patients with chronic severe hepatitis B have a high secondary infection rate and complicated clinical manifestations. G-bacilli are common pathogens and infection is an important factor affecting prognosis.