肝炎后肝硬化患者医院肺部感染临床分析  

Nosocomial Pneumonia in Patients with Post-hepatitis Liver cirrhosis:A Clinical Analysis

作　　者：胡国信[1] 郑洁[2] 何颖[1] 张伦理[1] 

机构地区：[1]南昌大学第一附属医院感染科,江西南昌330006 [2]江西省中医院呼吸内科,江西南昌330006

出　　处：《中华医院感染学杂志》2009年第23期3195-3197,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究肝炎后肝硬化患者医院肺部感染的临床特征及其危险因素。方法采用回顾性病例对照方法对医院2005年1月1日-2007年12月31日感染内科495例肝炎后肝硬化住院患者进行调查统计分析。结果肝炎后肝硬化患者医院肺部感染的发生率为13.50%;病死率25.40%,显著高于无感染患者的病死率6.80%(2χ=23.77,P<0.01);临床表现早期不典型;主要危险因素是年龄、住院时间、低蛋白血症、疾病严重程度、侵入性操作、广谱抗菌药物使用、肝性脑病、上消化道出血等。结论肝硬化患者医院肺部感染是由多种因素共同作用的结果,临床医务人员在临床工作中应予重视并加强防护,减少医院内肺部感染的发生。OBJECTIVE To investigate the clinical characteristics,risk factors and preventive measures for nosocomial pneumonia in patients with post-hepatitis liver cirrhosis.METHODS A prospective and retrospective study was carried out to investigate the clinical data of 495 patients with post-hepatitis liver cirrhosis in Department of Infectious Diseases during Jan 1,2005 to Dec 31,2007.RESULTS The incidence rate of the nosocomial pneumonia in post-hepatitis liver cirrhosis patients was 13.50 %.The death rate was 25.40 %,which was obviously higher than 6.8% of patients without no nosocomial infection（χ2=23.77,P〈0.01）.The clinical features of nosocomial pneumonia in patients were usually untypical.The main risk factors were closely associated with patient′s age,hospitalization time,hypoalbuminemia,liver function,the invasive operations,hepatic encephalopathy,time of using broad-spectrum antibiotics,upper digestive tract bleeding et al.CONCLUSIONS Various factors contribute to nosocomial pneumonia in patients with severe viral hepatitis.The results suggest that we should pay attention to clinical treatment and nursing in order to lower the occurrence of the nosocomial pneumonia.

关 键 词：肝炎后肝硬化 医院肺部感染 临床分析 

分 类 号：R181.32[医药卫生—流行病学]