预防性抗生素应用对肝硬化并消化道出血患者医院感染的影响  

The Effects of Preventing Use Antibiotics on the Prognosis of Cirrhotic Patients with Acute Upper Gastrointestinal Hemorrhage

作　　者：王蕾[1] 鲍中英[1] 苑晓冬[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院感染科,北京100038

出　　处：《标记免疫分析与临床》2015年第7期617-619,共3页Labeled Immunoassays and Clinical Medicine

摘　　要：目的对肝硬化上消化道出血并发医院感染患者使用抗菌药物进行观察分析,为临床治疗提供参考。方法选择医院2012年1月至2013年12月收治的180例肝硬化合并上消化道出血的患者作为研究对象,将所有患者随机分成头孢曲松钠组、左氧氟沙星组和对照组各60例,对照组不用抗菌药物,观察比较三组患者医院感染率、再出血率和住院期间死亡率等。结果头孢曲松钠组患者医院感染率为8.33%,再出血率为8.33%,明显好于对照组(P<0.05),左氧氟沙星组其医院感染率、再出血率分别为10.0%、6.67%,明显好于对照组(P<0.05),但抗生素两组间医院感染率、再出血率比较差异无统计学意义。三组间病死率无统计学差别。结论肝硬化并上消化道出血患者预防性抗生素应用,可降低医院感染发生率和再出血率,具有临床应用价值。Objective To study the effect of antibiotics prophylaxis on nosoeomial infection in liver cirrhotic patients with acute upper gastrointestinal hemorrhage so as to provide basis for the clinical treatment. Methods From January 2012 to December 2013, 180 cases with liver cirrhosis combined with upper gastrointestinal bleeding were selected as the research objects. All the patients were randomly divided into the ceflriaxone sodium group （60 cases）, levofloxacin group （60 cases） and control group （60 cases） ; the control group without antibiotics. The rates of nosocomial infection and re-bleeding, the mortality were observed and compared. Results The rate of nosocomial infection and the rate of re-bleeding in Ceftriaxone sodium group were 8.33% and 8.33% respectively and it was better than the control group （P 〈 0.05 ）. The rate of nosocomial infection and the rate of re-bleeding in Levofloxacin group were 10.0% and 6.67% respectively and it was better than the control group （P 〈 0.05 ）. The rate of nosocomial infection and re- bleeding had no statistical significance between the two antibiotics groups. There was no statistical difference between the mortality（5.0% vs 3.33% vs 8. 33% ） in three groups. Conclusion The preventing use antibiotics on cirrhotic patients with upper gastrointestinal hemorrhage can reduce the rates of nosocomial infection and re-bleeding with significant value in clinical application.

关 键 词：肝硬化 上消化道出血 抗生素预防 

分 类 号：R57[医药卫生—消化系统]