大疱性类天疱疮患者感染分析

发布时间：2018-03-25 13:11

本文选题：大疱性类天疱疮　切入点：感染　出处：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨大疱性类天疱疮患者的感染情况,并分析诱发感染的相关危险因素,为临床治疗提供参考。方法对杭州市第三人民医院收治的大疱性类天疱疮患者116例临床资料进行回顾性分析,所有患者均根据病情轻重程度选取个体化治疗方案,以糖皮质激素治疗为主,并积极给予其他相关治疗;观察并记录患者的转归及感染情况,分析感染率与年龄、性别、血白蛋白水平、病情严重程度的关系。结果 116例患者中,病情缓解110例,缓解率为94.83%,不详者5例,死亡1例,病死率为0.86%;重症患者缓解率(83.33%)明显低于中轻症患者(100.00%),差异有统计学意义(P0.05);116例患者中,发生感染25例,感染率为21.55%;其中细菌感染24例,感染率为20.69%;真菌感染4例,感染率为3.45%;感染部位包括皮肤感染19例,肺部感染3例,败血症2例,尿路感染3例,口腔感染4例;其中合并2种感染2例(中症1例,重症1例),合并3种感染2例(均为重症);共分离出病原菌31株,主要病原菌为金黄色葡萄球菌、溶血葡萄球菌、大肠埃希菌和白念珠菌,分别占35.48%、19.35%、16.13%、12.90%;患者感染率与病情程度及血白蛋白水平有关,血白蛋白水平较低者感染率(35.29%)大于血白蛋白水平较高者(15.85%);重症大疱性类天疱疮感染率(44.44%)大于中症(11.48%)、轻症(10.53%)患者。结论大疱性类天疱疮患者合并感染发病率较高,感染率与病情程度和血白蛋白水平有明显相关性;病原菌以金黄色葡萄球菌最为常见,在临床工作中,要重视此类患者的皮肤护理及感染防控。
[Abstract]:Objective to investigate the infection in patients with bullous pemphigoid and to analyze the risk factors of inducing infection. Methods the clinical data of 116 patients with bullous pemphigoid in the third people's Hospital of Hangzhou were analyzed retrospectively. The main treatment was glucocorticoid therapy, and other related treatments were given, the prognosis and infection of the patients were observed and recorded, and the relationship between infection rate and age, sex, serum albumin level, severity of the disease was analyzed. The remission rate was 94.83%, the remission rate was 94.83%, 5 cases were unknown, 1 case died, and the mortality rate was 0.86; the remission rate of severe patients was significantly lower than that of moderate and mild patients with 100.000.0.The difference was statistically significant in the 116 patients with moderate or mild disease. The infection rate was 21.55. Bacterial infection was found in 24 cases (20.69%), fungal infection in 4 cases (3.45%), skin infection in 19 cases, pulmonary infection in 3 cases, septicemia in 2 cases, urinary tract infection in 3 cases, oral infection in 4 cases. Among them, 2 cases were complicated with 2 kinds of infection (1 moderate, 1 severe, 2 combined with 3 kinds of infection), 31 strains of pathogenic bacteria were isolated, the main pathogens were Staphylococcus aureus, Staphylococcus haemolyticus, Escherichia coli and Candida albicans, the main pathogens were Staphylococcus aureus, Staphylococcus haemolyticus, Escherichia coli and Candida albicans. The infection rate of the patients was related to the degree of illness and the level of serum albumin. The infection rate of patients with lower serum albumin level (35.29) is greater than that of those with higher serum albumin level (15.85%), the infection rate of severe bullous pemphigoid is 44.44) is greater than that of moderate disease 11.48%, mild disease 10.53). Conclusion the incidence of infection in patients with bullous pemphigoid is higher than that in patients with bullous pemphigoid. The infection rate was significantly correlated with the severity of the disease and the level of serum albumin, and Staphylococcus aureus was the most common pathogen. In clinical work, attention should be paid to the skin care and infection prevention and control of such patients.
【作者单位】：杭州市第三人民医院皮肤科;杭州市第三人民医院康复科;
【基金】：浙江省卫生厅基金资助项目(2013KYB2690)
【分类号】：R758.66

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