抗菌药物预防性应用降低肝硬化上消化道出血患者院内感染的临床研究  

The prophylactic use of antibiotics to reduce nosocomial infection in patients with cirrhosis and upper gastrointestinal hemorrhage

作　　者：姚丽君 姜玲玲[2] 庄朋凤 

机构地区：[1]浙江省长兴县人民医院消化内科,浙江长兴313100 [2]浙江大学医学院附属第一医院消化内科,浙江杭州310003 [3]江苏省苏州市第一人民医院消化内科,江苏苏州215000

出　　处：《中国现代医生》2014年第1期11-13,共3页China Modern Doctor

基　　金：浙江省医学会医学发展计划一般资助项目(2010-ZW046)

摘　　要：目的探讨抗菌药物用于预防肝硬化上消化道出血患者院内感染的临床效果。方法选取肝硬化上消化道出血患者110例,随机分为两组,其中对照组53例,观察组57例。对照组患者实施常规治疗,观察组患者在对照组治疗基础上给予2.0 g头孢噻肟钠静脉滴注,连续应用7 d。对两组患者感染发生情况、死亡率以及生活质量进行评价和比较。结果分别有26.32%和17.54%的观察组患者发生医院感染和死亡,对照组分别为52.83%和35.83%,观察组患者明显少于对照组。观察组患者发生自发性腹膜炎、肺部感染、肠道感染、感染性休克、混合感染者分别占17.54%、3.51%、8.77%、1.75%和10.53%,对照组分别为30.19%、15.09%、13.21%、9.43%、15.09%和52.83%,观察组患者均明显少于对照组;观察组患者发生医院感染的平均时间为(10.68±1.33)d,对照组为(5.74±1.59)d,观察组患者明显晚于对照组;观察组患者生活质量量表中日常生活、社会生活、抑郁、焦虑以及总分均明显低于对照组。两组差异有统计学意义(P<0.05)。结论预防性应用抗菌药物可以有效降低肝硬化上消化道出血患者医院感染的发生率和死亡率,延缓感染发生时间,提高患者生活质量,可以作为肝硬化上消化道出血患者的常规治疗内容在临床工作中进行推广和应用。Objective To investigate the clinical effect of antibacterial drugs for prevention of nosocomial infection in patients with cirrhosis and upper gastrointestinal hemorrhage. Methods Liver cirrhosis patients with upper gastrointestinal bleeding in 110 cases, were randomly divi ded into two groups, including 53 cases in the control group, the observation group of 57 cases. Control the implementation of routine patients in the treatment group, the patients in observation group in the control group based on the given 2.0 g cefotaxime sodium intravenous injection, continuous application of 7 d. The two groups of patients with infection incidence, mortality and quality of life were evaluated and compared. Results The patients in the observation group were respectively 26.32% and 17.54% of the nosocomial infection and death, the control group were 52.83% and 35.83%, the patients in the observation group were significantly lower than the control group. The observation group occurred in patients with spontaneous bacterial peritonitis, pulmonary infection, intestinal infection, septic shock, mixed infection were 17.54%, 3.51%, 8.77%, 1.75% and 10.53%, the control group were 30.19%, 15.09%, 13.21%, 9.43%, 15.09% and 52.83%, the patients in observation group were significantly less than that of the control group; the patients in observation group average time the hospital infection was （10.68± 1.33） d, the control group （5.74±1.59） d, the patients in observation group was obviously later than the control group; the observation group patients quality of life scale in daily life, social life, depression, anxiety, and the scores were significantly lower than the control group. The two groups differed significantly, with statistical significance （P 〈 0.05）. Conclusion Prevention can effectively decrease the incidence and mortality of nosocomial infection in patients with cirrhosis and upper gastrointestinal hemorrhage of antimicrobial agents application, delay the time of infection, improve the quality of life of

关 键 词：抗菌药物 预防应用 肝硬化 上消化道出血 院内感染 

分 类 号：R978.1[医药卫生—药品]