重症肝炎并发医院感染的危险因素分析  

Analysis of risk factors for severe hepatitis complicated with nosocomial infection

作　　者：熊英[1] 

机构地区：[1]南昌大学第一附属医院感染科,江西南昌330006

出　　处：《中华医院感染学杂志》2011年第22期4727-4728,4695,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析重症肝炎并发医院感染的相关因素及危险因素。方法设计统一表格,对190例患者病例资料进行统计分析,内容包括,患者年龄、性别,医院感染部位、病原菌、病死率、住院时间、侵入性操作、免疫抑制剂使用、抗菌药物使用情况等。结果医院感染率为21.3%,医院感染死亡率为55.3%,感染部位主要为腹腔占46.3%,其次为下呼吸道感染占21.6%;从血、痰、尿、粪及腹水取样细菌学培养检查中,共培养分离出病原菌39株,主要致病菌为革兰阳性球菌,占23.1%,其次为肺炎克雷伯菌占18.0%;患者年龄、住院时间、侵入性操作和抗菌药物的应用与医院感染呈正相关。结论住院时间、侵入性操作及抗菌药物应用时间,是重型肝炎患者易并发医院感染的主要危险因素;尽量缩短住院时间、合理使用抗菌药物以减少重型肝炎患者的医院感染率。OBJECTIVE To analyze the risk factors for severe hepatitis complicated with nosocomial infection. METHODS The investigation form was designed,and the data of 190 patients was analyzed,including patient age,gender,nosocomial infection,hospital infection bacteria and hospital infection case fatality rate,hospitalization time,invasive operation,use of immunosuppressive drugs and antibiotic use. RESULTS The hospital infection rate was 21.3%,hospital infection mortality rate was 55.3%.The main infection site was the peritoneal cavity,accounting for 46.3%,the next was lower respiratory tract infection,accounting for 21.6%,totally 39 strains of pathogens were cultured and isolated from the blood,sputum,urine,feces and ascites,the main pathogens were positive cocci,accounting for 23.1%,followed by Klebsiella pneumoniae,accounting for 18.0%.Hospital infection was related to age,duration of hospitalization,invasive procedures and the application of antibiotics. CONCLUSION The major nosocomial risk factors for severe hepatitis complicated with nosocomial infection are the duration of hospitalization,invasive operation and application of antibiotics time.To shorten the duration of hospitalization as much as possible and reasonably use antibiotics can reduce the nosocomial infection rate of patients with severe hepatitis.

关 键 词：重症肝炎 医院感染 危险因素 

分 类 号：R512.62[医药卫生—内科学]