肝硬化失代偿期患者真菌感染多因素分析

发布时间：2019-06-19 12:12

【摘要】：目的探讨肝硬化失代偿期患者真菌感染临床特点及危险因素,为临床诊治提供参考。方法选择2007年6月-2014年6月434例肝硬化失代偿期患者,统计其真菌感染率,分析感染分布及真菌特点,对年龄、性别、肝功能分级、消化道出血等潜在因素进行单因素及多因素分析。结果 434例患者真菌感染42例感染率为9.68%,42例感染患者送检标本中有33例培养阳性,分离出35株真菌,以白色假丝酵母菌、热带假丝酵母菌为主分别占37.14%、22.86%;单因素分析结果提示,感染未规范抗病毒治疗、肝功能Child-Pugh分级-C级、消化道出血、重度低蛋白血症、抗菌药物使用7d、腹膜炎、侵入性操作为感染因素,差异均有统计学意义(P0.05);肝功能Child-Pugh分级-C、抗菌药物使用7d、重度低蛋白血症、侵入性操作、消化道出血是真菌感染的独立危险因素(P0.05)。结论肝硬化失代偿期患者真菌感染率高,危险因素复杂,临床需加强早期干预降低感染率。
[Abstract]:Objective to investigate the clinical characteristics and risk factors of fungal infection in decompensated patients with liver cirrhosis, and to provide reference for clinical diagnosis and treatment. Methods from June 2007 to June 2014, 434 patients with decompensated liver cirrhosis were enrolled in this study. the fungal infection rate was analyzed, the distribution and characteristics of fungi were analyzed, and the potential factors such as age, sex, liver function grade and gastrointestinal bleeding were analyzed. Results the infection rate of 42 cases of fungal infection in 434 patients was 9.68%. 33 of the 42 infected patients were positive for culture. 35 strains of fungi were isolated, mainly candida albicans and candida tropicalis, accounting for 37.14% and 22.86%, respectively. The results of univariate analysis showed that unstandardized antiviral therapy, Child-Pugh grade C of liver function, gastrointestinal bleeding, severe hypoalbuminemia, use of antibiotics for 7 days, peritonitis and invasive operation were the infection factors, the difference was statistically significant (P 0.05). Liver function Child-Pugh grade-C, antibiotics for 7 days, severe hypoalbuminemia, invasive operation, gastrointestinal bleeding were independent risk factors for fungal infection (P 0.05). Conclusion the fungal infection rate is high and the risk factors are complex in decompensated patients with liver cirrhosis. early intervention should be strengthened to reduce the infection rate.
【作者单位】：台州市肿瘤医院感染内科;
【基金】：浙江省卫生厅基金资助项目(2013KYB287)
【分类号】：R575.2

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