摘要
目的探究抗菌药物联合人免疫球蛋白在治疗重症肝病合并感染患者的临床治疗效果及对总胆红素(TB)及凝血酶原时间(PT)的影响。方法选取2012年5月-2016年6月医院收治的200例重症肝病合并医院感染的患者为研究对象,分为对照组和试验组,每组100例,并按照肝脏储备功能量化评估分级标准(Child-Pugh评分)分为<10分和10~15分患者;对照组患者采用头孢三代抗菌药物治疗,试验组患者在对照组患者的治疗基础上加用人免疫球蛋白治疗;对两组患者的病原菌进行检测;测定两组患者治疗前肝功能指标及感染类型;统计两组患者的临床抗感染效果;测定两组患者入院时和治疗结束时TB及PT的变化;统计两组患者治疗过程中并发症发生情况。结果对照组患者采集100例标本,共检测到病原菌178株;试验组患者采集100例标本,共检测到病原菌180株;试验组Child-Pugh评分10~15分的患者抗感染有效率为88.33%,高于对照组的70.18%(P<0.05);治疗后,两组患者TB及PT均有所下降(P<0.05);与对照组患者相比,试验组Child-Pugh评分10~15分的患者治疗后TB与PT的值均有所下降(P<0.05);试验组患者治疗过程中的并发症发生率为29.00%,低于对照组患者的并发症发生率48.00%(χ~2=7.623,P=0.006)。结论 Child-Pugh评分10~15分的重症肝病合并感染的患者采用抗菌药物联合人免疫球蛋白治疗,具有较好的抗感染作用,并能够降低患者血清中TB的浓度,减少PT,具有重要的临床价值。
OBJECTIVE To explore the clinical efficacy of antibacterial agents combined with human immunoglobulin in the treatment of patients with severe liver disease and infection,and the effects on total bilirubin and prothrombin time.METHODS A total of 200 patients with severe liver disease complicated with nosocomial infection admitted to our hospital from May 2012 to June 2016 were selected as the research subjects.According to the random number table,the patients were divided into control group and observation group,with 100 cases in each group.According to Child-Pugh classification,the patients were divided into10 group and 10～15 group.Patients in the control group were treated with the third generation of the antibiotics cephalosporin,whereas the observation group patients were treated with human immunoglobulin therapy in addition to the medication of the control group.Both groups of patients were tested for pathogenic bacteria.Indicators of liver function and types of infections of both groups of patients were tested before treatment.The clinical anti-infective effects of the two groups of patients were statistically analyzed.The changes of TB and PT at the time of admission and at the end of treatment were measured in both groups.The incidence of complications in the two groups were calculated.RESULTS In the control group,100 specimens were collected and 178 pathogens were detected.In the observation group,100 specimens were collected and 180 strains of pathogens were detected.In the control group,the effective rate of anti-infection in patients with Child-Pugh score of 10～15 was 88.37%,higher than that of the control group（70.18%）（P〈0.05）.After treatment,the TB and PT in both groups were significantly decreased（P〈0.05）.Compared with the control group,the values of TB and PT in the patients with Child-Pugh scores of 10～15 in the observation group were significantly decreased after treatment（P〈0.05）.In the observation group,29 cases（29.00%）had complication during the treatment,which was significantly less than that in the control group（48.00%）（χ^2=7.623,P=0.006）.CONCLUSION When patients with severe liver disease complicated with infection and with a Child-Pugh score of 10～15 were treated with antimicrobial agents combined with human immunoglobulin,a significant anti-infective effect was achieved,and both the serum total bilirubin concentration and prothrombin time could be reduced,which has an important clinical value.
作者
施雯宇
王章
徐婷婷
戴璋达
方建珍
SHI Wen-yu;WANG Zhang;XU Ting-ting;DAI Zhang-da;FANG Jian-zhen(PLA 118 Hospital,Wenzhou,Zhejiang 325000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第16期2430-2434,共5页
Chinese Journal of Nosocomiology
基金
江苏省自然科学基金资助项目(BK2011100)
