摘要
目的探究肝硬化合并上消化道出血患者医院感染的病原学特点及影响因素,以期预防和控制医院感染。方法选择2014年5月-2017年5月在医院治疗的225例肝硬化合并上消化道出血患者为研究对象,回顾性分析患者的临床资料,单因素和多因素logistic回归分析患者发生医院感染的影响因素。采集患者感染部位标本进行病原菌培养及鉴定。结果 225例肝硬化合并上消化道出血患者发生医院感染36例,感染率为16.00%,其中最易发生感染的部位是呼吸道;36例发生医院感染患者体液标本经过培养与鉴定,共分离培养出病原菌42株,其中革兰阴性菌22株占52.38%,以大肠埃希菌为主;多因素Logistic回归分析显示:年龄>60岁、住院时间>4周、侵入性操作、肝功能child分级为C级为肝硬化合并上消化道出血患者医院感染的独立影响因素。结论肝硬化合并上消化道出血患者医院感染率高,危害严重,医护人员应采取有效的预防措施,尽量避免出现医院感染。
OBJECTIVE To explore the etiological characteristics and influencing factors for nosocomial infection in liver cirrhosis patients complicated with upper gastrointestinal hemorrhage so as to prevent the nosocomial infection and improve the prognosis.METHODS A total of 225 liver cirrhosis patients complicated with upper gastrointestinal hemorrhage who were treated in the hospital from May 2014 to May 2017 were recruited as the study objects,the clinical data of the patients were retrospectively analyzed,the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infection,the specimens were collected from the infection sites of the patients,and the pathogens were isolated and identified.RESULTS Of the225 liver cirrhosis patients complicated with upper gastrointestinal hemorrhage,36 had nosocomial infection,with the infection rate 16.00%;the respiratory tract was the major infection site.Totally 42 strains of pathogens were isolated from the body fluid specimens of the 36 patients with nosocomial infection,22(52.38%)of which were gram-negative bacteria;Escherichia coli was the predominant species of the gram-negative bacteria.The multivariate logistic regression analysis indicated that the more than 60 years of age,length of hospital stay more than 4 weeks,invasive operations and grade C of liver function child classification were the independent influencing factors for the nosocomial infection in the liver cirrhosis patients complicated with upper gastrointestinal hemorrhage.CONCLUSIONThe incidence of nosocomial infection is high among the liver cirrhosis patients complicated with upper gastrointestinal hemorrhage,with the harm severe.It is necessary for the health care workers to take effective prevention measures so as to prevent the nosocomial infection.
作者
徐升
徐芳
应丽园
陈明彤
黄绿澜
祝芳
XU Sheng;XU Fang;YING Li-yuan;CHEN Ming-tong;HUANG Lyu-lan;ZHU Fang(The First People's Hospital of Yongkang,Yongkang,Zhejiang 321300,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期71-74,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技基金资助项目(2014ZDA002)
关键词
肝硬化
医院感染
上消化道出血
感染因素
Liver cirrhosis
Nosocomial infection
Upper gastrointestinal hemorrhage
Factor for infection
