预防性使用头孢吡肟对肝硬化失代偿期上消化道出血患者院内感染的影响  

Effect of prophylactic use of Cefepime on nosocomial infection in cirrhosis patients with upper digestive tract hemorrhage

作　　者：张莹[1] 邵琼[2] 熊丽[3] 

机构地区：[1]鄂州市中心医院重症医学科,湖北鄂州436000 [2]鄂州市中心医院药学部,湖北鄂州436000 [3]鄂州市中心医院检验科,湖北鄂州436000

出　　处：《中国中西医结合消化杂志》2017年第5期369-371,375,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]观察预防性使用头孢吡肟对肝硬化失代偿期上消化道出血患者院内感染的预防作用,以及相关的临床意义。[方法]2014年7月~2016年7月我院收治的肝硬化失代偿期上消化道出血患者88例,使用信封法将88例患者随机分为对照组和观察组,每组44例。对照组给予基础治疗对症治疗,观察组在对照基础上预防性使用头孢吡肟1g溶于100ml 0.9%氯化钠注射液中,静滴,1次/d,连续用药7d。比较2组院内感染、再出血、死亡发生率,以及凝血酶原时间和住院天数的差异。[结果]2组患者院内感染主要以腹腔感染为主,其次为呼吸道和胃肠道感染,观察组的院内感染发生率为27.3%(12/44),显著低于对照组的52.3%(23/44)(P<0.05)。观察组再出血发生率为22.7%(10/44),显著低于对照组的40.9%(18/44)(P<0.05)。观察组死亡率为18.2%(8/44),显著低于对照组的38.6%(17/44)(P<0.05)。观察组血酶原时间为(16.14±1.37)s,显著低于对照组的(17.32±1.52)s(P<0.05)。观察组的住院时间为(15.61±2.72)d,显著短于对照组的(21.82±4.16)d(P<0.05)。2组之间感染的病原菌种类差异无统计学意义(P>0.05)。[结论]预防性使用头孢吡肟可以显著减低肝硬化失代偿期上消化道出血患者院内感染的发生率,降低患者的再出血发生率和死亡率。[Objective] To detect the effect of prophylactic use of Cefepime on nosocomial infection in cirrhosis patients with upper digestive tract hemorrhage. [Methods]88 cirrhosis patients with upper digestive tract hemorrhage were enrolled in this study and randomly divided into control group and observation group,with each group of 44 cases. The control group was given basic treatment, and the observation group was given Chloride（1 g,1 times/d,continuous 7 d） on the basis of control group. The difference of hospital infection,rebleeding, mortality, prothrombin time, and length of hospital stay was compared between the two groups. [Results]The two groups of patients with nosocomial infection were mainly abdominal infection,followed by respiratory and gastrointestinal infections. The incidence rate of nosocomial infection in observation group was 27.3% （12/44）,which was significantly lower than that of 52.3% （23/44）in control group（P〈0.05）. The incidence rate of re bleeding in observation group was 22.7% （10/44）,which was significantly lower than that of 40.9%（18/44）in control group（P〈0.05）. The mortality rate of the observation group was 18.2 % （8/44）, which was significantly lower than that of 38.6 % （17/44）in control group （P〈0.05）. The prothrombin time in observation group was 16.14 ±1 37 s,which was significantly lower than that of 17.32 ±1 52 s in control group（P〈0.05）. The length of hospital stay in observation group was 15.61 ±2.72 d,which was significantly shorter than that of 21.82 ± 4.16 d in control group（P〈 0.05）. There was no significant difference of pathogenic bacteria between the two groups（P〉0, 05）. [Cono clusion]Prophylactic use of Cefepime significantly reduced the incidence of nosocomial infection in cirrhosis patients with upper digestive tract bleeding,which also reduced the incidence of recurrent hemorrhage and mortality.

关 键 词：头孢吡肟 肝硬化失代偿期 上消化道出血 院内感染 

分 类 号：R575.2[医药卫生—消化系统]