预防性应用抗生素对肝硬化上消化道出血患者短期预后及安全性观察  

Short term prognosis and safety of prophylactic use of antibiotics in patients with liver cirrhosis complicated with upper gastrointestinal bleeding

作　　者：李梦帆 李静 LI Mengfan;LI Jing(Department of Gastroenterology,The First Afiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]锦州医科大学附属第一医院消化内科,121000

出　　处：《中国老年保健医学》2023年第2期68-71,共4页Chinese Journal of Geriatric Care

摘　　要：目的 通过回顾性研究观察预防性应用抗生素对肝硬化合并上消化道出血(UGIB)的短期预后及安全性。方法 选取2016年1月至2021年12月在锦州医科大学附属第一医院消化内科确诊为肝硬化(LC)合并上消化道出血(UGIB)的住院患者117例,按照患者入院时是否预防应用抗菌药物分为试验组(n=69)及对照组(n=48),观察记录两组患者的短期预后及药物不良反应。结果 研究结果显示,试验组和对照组短期预后比较分别为:院内感染率为11.6%和22.5%,1周内再出血率为7.2%和22.9%,肝性脑病的发生率为5.8%和18.8%,48小时内止血为89.9%和75.0%,差异有统计学意义(P<0.05);在肝肾综合征和2周病死率的发生率上比较,差异无统计学意义(P>0.05);在两组患者药物总不良反应率的比较上,试验组和对照组分别为14.5%和16.7%,比较差异无统计学意义(P>0.05)。结论 预防性使用抗生素可以增加肝硬化合并上消化道出血患者的止血疗效,降低再出血、院内感染、肝性脑病的发生率且不会增加新的药物不良反应,可以改善患者短期预后,安全性较为可靠。Objective Through a retrospective study to observe the short-term prognosis and safety of preventive use of antibiotics for liver cirrhosis with upper gastrointestinal bleeding.Methods 117 patients with liver cirrhosis(LC)and upper gastrointestinal bleeding(UCIB)diagnosed in the Department of Gastroenterology of the First Affiliated Hospital of Jinzhou Medical University from January 2016 to December 2021 were selected,the patients were divided into experimental group(n=69)and control group(n=48)according to whether they were prevented from using antibacterial drugs at admission.The short-term prognosis and adverse drug reactions of the two groups was observed and recorded.Results According to the results of this study,the short-term prognosis of the experimental group and the control group were as follows:the nosocomial infection rate was 11.6%vs22.5%,the rebleeding rate within 1 week was 7.2%vs22.9%,the incidence of hepatic encephalopathy was 5.8%vs18.8%,and the hemostasis within 48h was 89.9%vs75.0%,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of hepatorenal syndrome and 2-week mortality(P>0.05).The total adverse reaction rate of the two groups was 14.5%and 16.7%,respectively,with no statistical significance(P>0.05).Conclusion Short-term prophylactic use of antibiotics can increase the hemostatic efficacy of patients with cirrhosis complicated with upper gastrointestinal bleeding,reduce the incidence of rebleeding,nosocomial infection and hepatic encephalopathy without increasing new adverse drug reactions,and can improve the short-term prognosis of patients with reliable safety.

关 键 词：肝硬化 上消化道出血 抗生素 不良反应 

分 类 号：R575.2[医药卫生—消化系统] R573.2[医药卫生—内科学]