肝硬化消化道出血院内感染的危险因素及其临床意义.doc

肝硬化消化道出血院内感染的危险因素及其临床意义 黄紫庆 袁桂林 冷佳源 沈薇 重庆医科大学附属第二医院消化内科400010 【摘 要】：目的 探讨肝硬化消化道出血患者院内感染的危险因素及其临床意义。方法 收集我院2009年10月份至2014年1月份肝硬化并发消化道出血患者的临床资料，分析院内感染、再出血的高危因素，预防性使用抗菌素对院内感染及再出血的影响。Child-Pugh分级 【中图分类号】： R575.2； R573.2 【文献标志码】 A Risk factors of nosocomial infection of liver cirrhosis patients with gastrointestinal bleeding and its clinical significance Huang Ziqing；Yuan Guilin；Leng Jiayuan ；Shen Wei (Department of Gastroenterology,the Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China) 【Objiective】: to investigate risk factors of nosocomial infection of liver cirrhosis patients with gastrointestinal bleeding and analysis its clinical significance.METHODS Collect Clinical data of liver cirrhosis inpatients with gastrointestinal bleeding from October 2007 to January 2014,to analysis the risk factors of nosocomial infection and rebleeding，and to discuss the affects of prophylactic antibiotics to the rates of nosocomial infection and rebleeding . RESULTS:1.the nosocomial infection rate of liver cirrhosis patients with gastrointestinal bleeding is 20.8%,the nosocomial infection rate of liver cirrhosis patients without gastrointestinal bleeding is 5.4%(P0.01)。2.infection group and non-infection group have obvious differences in WBC count、Child-Pugh score、bleeding way、prophylactic antibiotics、nosocomial rebleeding(P0.05)。3.compare rebleeding group with non-rebleeding group，two group have obvious differences in age、WBC count、Child-Pugh score。4.the nonsocial infection rate of prophylactic antibiotics group and non-prophylactic antibioticsgroup is 11.3%、27.8%，have significant difference (P0.01)，their rebleeding rate is 13.0%、12.0%，have insignificant difference（P0.05）。5.multivariate analysis indicated tha haematemesis、Child-Pugh score、high WBC count were independent risk factors of nonsocial infection，their odd ratio were 3.119（95%CI=1.383～7.034, P0.01）、2.405（95%CI=1.129～5.123, P0.01）、1.241（95%CI=1.073～1.435, P0.01）CONCLUSION leeding increase live