肝硬化患者合并细菌感染的生存率及生活质量分析  

Survival rate and quality of life in patients with liver cirrhosis complicated with bacterial infection

作　　者：辛金换 郭亚卿 刘洋 范敬静[1] 明喜梅 高晶 陈勇[1] 常彩芳[1] XIN Jinhuan;GUO Yaqing;LIU Yang;FAN Jingjing;MING Ximei;GAO Jing;CHEN Yong;CHANG Caifang(Department of Infectious Diseases,First Affiliated Hospital of Hebei North University Zhangjiakou,Hebei 075000,China;Infection Management Department of the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院感染性疾病科,河北张家口075000 [2]河北北方学院附属第一医院感染管理处,河北张家口075000

出　　处：《公共卫生与预防医学》2024年第2期101-105,共5页Journal of Public Health and Preventive Medicine

基　　金：2023年度河北省医学科学研究课题计划(20231447)。

摘　　要：目的 分析肝硬化合并细菌感染患者的短期生存情况及预后生活质量状况。方法 研究收集河北北方学院附属第一医院住院治疗的肝硬化合并感染患者300例患者纳入分析,并随访描述讨论生存情况和生活质量情况。结果 感染原因前两位分别为自发性细菌性腹膜炎患者(60.67%)和肺炎(50.67%);其次分别为尿路感染(15.33%),消化道感染(12.33%)以及其他原因,男女患者间差异无统计学意义(P>0.05)。院内感染比例为71.00%,男女患者间差异无统计学意义(P>0.05)。分离病原菌,研究中总共检出病原菌353株(院内感染患者的病原菌占73.37%),病原菌分布分析可见大肠埃希菌比例最高,为35.98%,其次为肺炎克雷伯杆菌(18.98%)。院内感染患者的259株病原菌中菌种分布趋势与全部菌株一致,差异无统计学意义(P>0.05)。革兰阴性菌占全部检出菌株的79.60%(281/353),其中大肠埃希菌较多检出于自发性细菌性腹膜炎患者,肺炎克雷伯杆菌(klebsiella Pneumoniae,KPN)和铜绿假单胞菌(pseudomonas aeruginosa,PAE)较多检出于肺炎患者,肠球菌(enterococcus,ENF)较多检出于尿路感染患者;革兰阳性菌中表皮葡萄球菌(staphylococcus epidermidis,SEP)和金黄色葡萄球菌(staphylococcus aureus,SAU)多见于其他感染原因患者(血流感染等),链球菌(streptococcus,STR)在自发性细菌性腹膜炎患者中所占比例较高。研究随访检出死亡预后9例,不同菌种在两性中的死亡预后检出差别以及院内感染和院外感染在两性中的死亡预后检出差异无统计学意义(P>0.05)。不同感染原因在两性间的死亡预后检出差异无统计学意义(P>0.05)。随访存活的291例患者,对比基线与随访的生活质量得分,可见随访得分均有所增加,特别是在生理机能和躯体疼痛维度的得分,在不同菌种之间、不同感染原因之间以及院内/非院内感染之间差异无统计学意义(P>0.05)。结论 自发性细菌性腹膜炎和Objective To analyze the short-term survival and prognostic quality of life of patients with liver cirrhosis complicated by bacterial infection.Methods This study collected and analyzed 300 patients with liver cirrhosis complicated with infection who were hospitalized in the First Affiliated Hospital of Hebei North University,and followed up to discuss their survival and quality of life.Results In this study,the top two causes of infection were spontaneous bacterial peritonitis(60.67%of patients)and pneumonia(50.67%of patients).The second causes were urinary tract infections(15.33%),gastrointestinal infections(12.33%),and other causes.There was no statistically significant difference between male and female patients(P>0.05).In addition,the proportion of hospital infections was 71.00%,and there was no statistically significant difference between male and female patients(P>0.05).A total of 353 strains of pathogenic bacteria were isolated in this study(73.37%of patients with hospital infections).The distribution analysis of pathogenic bacteria showed that the highest proportion of ECO was 35.98%,followed by Klebsiella pneumoniae(18.98%).The distribution trend of 259 strains of pathogenic bacteria among hospital patients was consistent with that of all strains,and the difference was not statistically significant(P>0.05).Gram negative bacteria accounted for 79.60%(281/353)of all detected strains,of which Escherichia coli was mostly detected in patients with spontaneous bacterial peritonitis,Klebsiella Pneumoniae(KPN)and Pseudomonas aeruginosa(PAE)were mostly detected in patients with pneumonia,and Enterococcus(ENF)was mostly detected in patients with urinary tract infection;Among gram-negative bacteria,Staphylococcus epidermidis(SEP)and Staphylococcus aureus(SAU)are mostly found in patients with other infectious causes(blood flow infection,etc.),and Streptococcus(STR)accounts for a high proportion in patients with Spontaneous bacterial peritonitis.In this study,9 cases of death prognosis were detected during follow-up

关 键 词：肝硬化 细菌感染 生存 生活质量 随访 

分 类 号：R181[医药卫生—流行病学]