肝硬化患者感染性休克临床特征及预后

发布时间：2018-06-29 06:38

本文选题：肝硬化患者 + 感染性休克　；参考：《中华医院感染学杂志》2015年05期

【摘要】：目的探讨肝硬化患者合并感染性休克的临床特征及预后,为早期预防和控制肝硬化患者感染性休克及提高患者的生存率提供科学依据。方法回顾性分析2013年1-12月527例肝硬化患者并发感染性休克86例的临床资料,探讨肝硬化患者合并感染性休克的临床特征及预后,总结应对策略。结果 527例肝硬化患者发生感染性休克86例,发生率为16.32%;其中未发生感染性休克的441例患者死亡10例,病死率为2.27%,发生感染性休克的86例患者死亡9例,病死率为10.47%;86例肝硬化患者发生感染部位主要为肺部感染38例占44.19%、腹腔及肠道感染27例占31.39%;送检标本分离出病原菌75株,革兰阴性杆菌41株占54.67%、革兰阳性球菌14株占18.67%、真菌20株占26.66%,肝硬化患者发生感染性休克的危险因素为年龄、血清白蛋白、预防性应用抗菌药物、消化道出血、肝性脑病、住院时间。结论根据肝硬化患者合并感染性休克的临床特征,并针对危险因素给予应对策略,对降低肝硬化患者感染性休克有重要的意义,可改善患者预后。
[Abstract]:Objective to investigate the clinical features and prognosis of patients with cirrhosis complicated with septic shock and to provide scientific basis for early prevention and control of septic shock and improvement of survival rate. Methods the clinical data of 86 patients with septic shock in 527 patients with liver cirrhosis from January to December 2013 were analyzed retrospectively. The clinical features and prognosis of patients with cirrhosis complicated with septic shock were discussed and the coping strategies were summarized. Results there were 86 cases of septic shock in 527 patients with liver cirrhosis, the incidence rate was 16.322.10 cases died of 441 cases without septic shock, the fatality rate was 2.27%, and 9 cases died of 86 cases of septic shock. The mortality rate of 86 patients with liver cirrhosis was 10.47. The main infection sites were pulmonary infection in 38 cases (44.19%), abdominal and intestinal infection in 27 cases (31.39%). 41 strains of Gram-negative bacilli accounted for 54.67%, 14 strains of Gram-positive cocci accounted for 18.67% and 20 strains of fungi accounted for 26.66.The risk factors for septic shock in patients with liver cirrhosis were age, serum albumin, prophylactic use of antimicrobial agents, gastrointestinal bleeding, hepatic encephalopathy. Length of stay. Conclusion according to the clinical characteristics of cirrhosis patients with septic shock and according to the risk factors, it is important to reduce septic shock and improve the prognosis of patients with cirrhosis.
【作者单位】：绍兴市第六人民医院重症医学科;绍兴市第六人民医院肝科;绍兴第二医院消化科;浙江大学医学院临床医学系;
【基金】：浙江省医药卫生科技基金资助项目(2012ADG287)
【分类号】：R575.2

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