天疱疮患者感染状况与干预措施研究

发布时间：2018-12-20 07:21

【摘要】：目的探讨天疱疮患者感染状况及预防感染的干预措施。方法选取医院2013年1月-2016年12月收治的56例天疱疮合并感染患者为感染组,选择同期住院治疗的天疱疮非感染患者60例为对照组,比较两组患者性别、年龄、病程、感染部位、住院天数、住院费用、激素用量等临床资料及痊愈率,感染组患者分别取血、尿、痰和伤口渗液等标本,进行病原菌鉴定。结果 56例天疱疮合并感染患者中感染部位前两位为皮肤软组织29例,占51.79%及口腔12例,占21.43%;56例天疱疮合并感染患者共检出病原菌64株,革兰阴性菌35株、革兰阳性菌27株、真菌2株,分别占54.69%、42.19%和3.13%;检出前4位的病原菌分别为肺炎克雷伯菌16株,占25.00%、金黄色葡萄球菌12株,占18.75%、表皮葡萄球菌8株,占12.50%和大肠埃希菌7株,占10.94%;感染组患者住院天数、住院费用和激素用量均显著高于对照组,两组比较差异有统计学意义(P0.05),痊愈率显著低于对照组,两组比较差异有统计学意义(P0.05)。结论天疱疮患者最常见的感染部位为皮肤软组织及口腔,感染病原菌以革兰阴性菌为主,继发感染可延长天疱疮住院时间,增加激素使用量和住院费用,预后较差。
[Abstract]:Objective to investigate the infection status of pemphigus patients and the intervention measures to prevent infection. Methods from January 2013 to December 2016, 56 patients with pemphigus complicated with infection were selected as infection group and 60 patients with pemphigus as control group. The sex, age and course of disease were compared between the two groups. The infection site, hospitalization days, hospitalization expenses, hormone dosage and cure rate were collected from the infected patients. The samples of blood, urine, sputum and wound exudate were collected to identify the pathogenic bacteria in the infected group. Results among 56 cases of pemphigus complicated with infection, 29 cases (51.79%) were skin and soft tissue, 12 cases (21.43%) were oral cavity. There were 64 pathogenic bacteria, 35 Gram-negative bacteria, 27 Gram-positive bacteria and 2 fungi, accounting for 42.19% and 3.13%, respectively, in 56 patients with pemphigus co-infection. The top 4 pathogens were Klebsiella pneumoniae 16 strains (25.00%), Staphylococcus aureus 12 strains (18.75%), Staphylococcus epidermidis 8 strains (12.50%) and Escherichia coli 7 strains (10.94%). The days of hospitalization, hospitalization expenses and hormone dosage in the infection group were significantly higher than those in the control group, the difference between the two groups was statistically significant (P0.05), the cure rate was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P0.05). Conclusion the most common infection sites in pemphigus patients are skin soft tissue and oral cavity. Gram-negative bacteria are the main pathogens of pemphigus infection. Secondary infection can prolong the hospitalization time of pemphigus, increase the use of hormones and hospital expenses, and the prognosis is poor.
【作者单位】：西南医科大学附属医院皮肤科;
【分类号】：R758.66

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