预防性应用抗生素对肝硬化上消化道出血患者感染的影响

发布时间：2018-10-31 12:06

【摘要】：目的探讨预防性应用抗生素对肝硬化上消化道出血患者感染的影响。方法选择肝硬化合并上消化道出血患者383例,根据治疗情况分为预防用药组210例和未预防用药组173例。预防用药组入院后在常规治疗基础上加用头孢曲松钠静脉滴注预防感染,对其过敏者(共2例)选用左氧氟沙星静脉滴注,治疗7 d;未预防用药组不使用抗生素。比较治疗10 d两组各类感染发生率、病原菌分布情况及上消化道再出血情况。结果预防用药组感染率为13.80%,未预防用药组感染率为36.99%,两组比较差异有统计学意义(P0.05);病原菌分布主要为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、屎肠球菌;未预防用药组患者的再出血率为20.23%,高于预防用药组患者的10.95%(P0.05)。结论肝硬化合并上消化道出血患者预防应用抗生素可降低相关细菌感染的发生和上消化道再出血。
[Abstract]:Objective to investigate the effect of prophylactic antibiotics on infection in patients with upper gastrointestinal hemorrhage due to liver cirrhosis. Methods 383 patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage were divided into two groups: the preventive group (210 cases) and the untreated group (173 cases). After admission, the prophylaxis group was treated with ceftriaxone sodium intravenous drip on the basis of routine treatment, and the allergic patients (2 cases) were treated with levofloxacin intravenous drip for 7 days, while no antibiotics were used in the non-prophylaxis group. The incidence of infection, the distribution of pathogenic bacteria and the rebleeding of upper digestive tract were compared between the two groups for 10 days. Results the infection rate of prophylaxis group was 13.80 and that of unprophylaxis group was 36.99. The difference between the two groups was statistically significant (P0.05). The main pathogens were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus faecium. Conclusion prophylactic use of antibiotics in patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage can reduce the incidence of bacterial infection and rebleeding of upper digestive tract.
【作者单位】：天津医科大学研究生院;天津市西青医院;天津市第二人民医院;泰达国际心血管医院;
【基金】：天津市卫生局科技基金项目(06KZ36)
【分类号】：R575.2

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