肝硬化失代偿期患者并发血流感染病原学特点及预后探究

发布时间：2018-03-09 04:10

本文选题：肝硬化　切入点：失代偿期　出处：《中华医院感染学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的研究肝硬化失代偿期患者并发血流感染的病原学特点及预后。方法选取于2010年2月-2016年8月医院收治的肝硬化失代偿期合并血流感染的患者89例作为观察组,提取患者血液标本进行细菌培养,对结果进行病原学分析和药敏实验分析;另选取同期的肝硬化失代偿期无感染患者89例作为对照组,通过肝功能检测,对两组患者的预后进行对比。结果 89例观察组患者的血液标本中,共分离出致病菌152株,其中革兰阴性菌60株占39.47%;革兰氏阳性菌92株占60.53%;药敏结果显示,表皮葡萄球菌对红霉素、青霉素等具有较强的耐药性,金黄色葡萄球菌对青霉素、阿奇霉素等具有较强耐药性,均对替考拉林、万古霉素等具有较强的敏感性;大肠埃希菌及肺炎克雷伯菌对磺胺甲VA唑/甲氧苄啶、阿莫西林等具有较强耐药性,而对头孢哌酮舒巴坦、派拉西林他唑巴坦等具有较强敏感性;肝功能检测结果显示,观察组总胆红素、凝血酶原时间、白蛋白分别为(103.3±53.4)μmol/L、(21.9±9.4)s、(27.6±10.8)g/L。对照组为(81.3±54.4)μmol/L、(16.8±10.2)s、(33.8±10.7)g/L,两组的各项数据之间的差异均具有统计学意义(P均0.05)。结论对于肝硬化失代偿期患者,其合并血流感染具有交叉耐药和多药耐药的特点;相比于无感染的患者,并发血流感染的患者预后更差。
[Abstract]:Objective to study the etiological characteristics and prognosis of blood flow infection in decompensated patients with cirrhosis. Methods 89 patients with decompensated cirrhosis complicated with blood flow infection were selected from February 2010 to August 2016 as the observation group. The blood samples of the patients were extracted for bacterial culture, the results were analyzed by etiology and drug sensitivity test, 89 patients with no infection in decompensated stage of cirrhosis were selected as the control group, and the liver function was measured. Results 152 strains of pathogenic bacteria were isolated from the blood samples of 89 patients in the observation group, of which 60 were Gram-negative bacteria (39.47g), 92 Gram-positive bacteria (60.53). Staphylococcus epidermidis has strong resistance to erythromycin and penicillin, Staphylococcus aureus has strong resistance to penicillin and azithromycin, all have strong sensitivity to teicoplanin and vancomycin. Escherichia coli and Klebsiella pneumoniae have strong resistance to sulfamethazol / trimethoprim and amoxicillin, but to cefoperazone sulbactam and paracillin tazobactam. The total bilirubin, prothrombin time and albumin were 103.3 卤53.4 渭 mol / L and 27.6 卤10.8 渭 mol / L 路L ~ (-1) 路L ~ (-1) respectively in the observation group and the control group were 81.3 卤54.4 渭 mol / L and 16.8 卤10.2 卤10.7 g / L, respectively. The difference between the two groups was statistically significant (P < 0.05). It has the characteristics of cross drug resistance and multi-drug resistance, and the prognosis of patients complicated with blood flow infection is worse than that of non-infection patients.
【作者单位】：海南医学院第二附属医院消化内科;
【基金】：海南省自然科学基金资助项目(309118)
【分类号】：R575.2

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