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目的:探讨肝硬化消化道出血患者发生医院内感染的危险因素,以选择抗菌药预防治疗的对象。方法:对以消化道出血入院的243例肝硬化患者的临床资料进行回顾性分析,根据是否合并医院内感染,将患者分为感染组与非感染组,分别比较两组的临床特征、实验室检查及治疗措施。结果和结论:109例患者发生医院内感染,发生率为44.9%,以腹腔感染最多见(51.4%,56/109),与非感染组相比,感染组入院时多伴有休克、Child-Pugh评分高、血白蛋白低、总胆红素高、住院期间更多地接受了内镜下治疗、停留三腔二囊管、静脉留置导管、使用血管加压素或生长抑素治疗。Logistic多元回归分析显示,停留三腔二囊管、静脉留置导管和Child-Pugh评分高是肝硬化消化道出血患者并发医院内感染的独立危险因素,对具有这些因素的患者应尽早给予抗菌药预防性治疗,以防医院内感染的发生。
Objective: To investigate the risk factors of nosocomial infection in patients with cirrhosis and gastrointestinal bleeding in order to choose the target of prophylactic treatment of antimicrobial agents. Methods: The clinical data of 243 patients with cirrhosis admitted to hospital with gastrointestinal bleeding were retrospectively analyzed. According to whether they were combined with nosocomial infection, the patients were divided into infected group and non-infected group. The clinical characteristics, Inspection and treatment measures. RESULTS AND CONCLUSION: The incidence of nosocomial infection in 109 patients was 44.9%, with the highest incidence of intra-abdominal infection (51.4%, 56/109). Compared with non-infected patients, infection in hospital was accompanied by more shock and Child- Pugh high score, low serum albumin, total bilirubin, more endoscopic treatment received during hospitalization, stop the three-chamber two balloon catheter indwelling catheter, the use of vasopressin or somatostatin treatment. Logistic multivariate regression analysis showed that stopping the triple-lumen balloon catheter, intravenous catheter and Child-Pugh high score were independent risk factors for nosocomial infection in patients with cirrhosis and gastrointestinal bleeding. Patients with these factors should be given antimicrobial prophylaxis as soon as possible Sexual treatment to prevent the occurrence of nosocomial infections.