摘要
目的分析乙型肝炎肝硬化肺部感染患者的临床特点,探讨影响其发生感染的危险因素,为临床治疗提供参考依据。方法选择2009年1月-2012年1月医院收治的乙型肝炎肝硬化患者356例,对发生肺部感染采用单因素和多因素logistic回归分析感染的影响因素;采用SPSS15.0软件进行数据统计分析。结果乙型肝炎肝硬化患者有80例发生肺部感染,感染率为22.47%、病死率为27.50%;感染组患者痰液经培养后分离出病原菌103株,其中革兰阴性菌46株占44.66%,革兰阳性菌51株占49.51%,真菌6株占5.83%;患者肺部感染与年龄、住院时间、病情严重程度、合并基础疾病、肝性脑病、上消化道出血、使用抗菌药物不合理、侵入性操作以及血清白蛋白含量具有显著关系(P<0.05);多因素logistic回归分析显示,病情严重程度、不合理使用抗菌药物、年龄≥60岁、住院时间、血清白蛋白<28g/L、上消化道出血、侵入性操作、肝性脑病和合并基础疾病均是影响患者肺部感染的危险因素。结论乙型肝炎肝硬化患者发生肺部感染是多种因素共同作用的结果,临床治疗中应给予重视并规范治疗。
OBJECTIVE To analyze the clinical characteristics of the hepatitis B patients with cirrhosis and pulmonary infections and explore the risk factors for the infections so as to provide guidance for clinical treatment.METHODS A total of 356hepatitis B patients with cirrhosis who were treated in the hospital from Jan 2009to Jan2012were enrolled in the study,then the univariate analysis and the multivariate logistic regression analysis were performed for the influencing factors for the infections,and the data were statistically analyzed with the use of SPSS15.0software.RESULTS Of the hepatitis B patients with cirrhosis,the pulmonary infections occurred in 80cases with the incidence rate of 22.47%;the mortality rate was 27.50%.A total of 103strains of pathogens have been isolated from sputum specimens obtained from the patients with infections,including 46（44.66%）strains of gram-negative bacteria,51（49.51%）strains of gram-positive bacteria,and 6（5.83%）strains of fungi.The incidence of pulmonary infections was significantly associated with the age,length of hospital stay,severity of disease,complication of underlying disease,hepatic encephalopathy,upper gastrointestinal bleeding,rational use of antibiotics,invasive operation,and content of serum albumin（P〈0.05）.The multivariate logistic regression analysis indicated that the severity of disease,unreasonable use of antibiotics,no less than 60years of age,length of hospital stay,content of serum albumin less than 28g/L,upper gastrointestinal bleeding,hepatic encephalopathy,and complication of underlying disease were the risk factors for the pulmonary infections.CONCLUSIONThe pulmonary infections in the hepatitis B patients with cirrhosis occur under the joint effect of multiple factors,which should be attached great significance to during the clinical treatment.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第14期3531-3533,共3页
Chinese Journal of Nosocomiology
基金
国家重点基础发展规划基金资助项目(973项目)(G123456789)
关键词
乙型肝炎肝硬化
肺部感染
危险因素
Hepatitis B with cirrhosis
Pulmonary infection
Risk factor
