慢性肝炎合并肝硬化患者医院感染病原菌分布和抗菌药物使用分析.docVIP

慢性肝炎合并肝硬化患者医院感染病原菌分布和抗菌药物使用分析 　　【中图分类号】R511 【文献标识码】A 【文章编号】1672－3783(2011)09－0368－01 　　【摘要】目的 分析慢性肝炎合并肝硬化患者医院感染病原菌分布与抗菌药物使用情况，探讨抗菌药使用的合理性；方法 回顾性分析了我院2007年1月至2011年3月收治的138例慢性肝炎合并肝硬化发生院内感染的患者，对其主要病原菌分布、抗菌药物使用情况进行了合理评价。结果 慢性肝炎合并肝硬化患者发生院内感染部位主要为腹腔、呼吸系统、血液、胆道及泌尿系统，呼吸系统主要为革兰氏阳性菌感染，而其他部位主要为革兰氏阴性菌感染；使用的抗菌药主要为喹诺酮类、第三代头孢菌素类以及含酶抑制剂复合物类，抗菌药在护肝和营养支持的基础上，采用联合用药的方式。结论 慢性肝炎合并肝硬化患者易发生院内感染，在临床操作中尽量避免违反无菌原则，降低院内感染发生率，对于感染患者，应根据细菌培养和药敏试验结果合理用药。? 　　【关键词】慢性肝炎；肝硬化；医院感染；抗菌药? 　　Pathogens Distribution and Use of Antibiotics in Chronic Hepatitis and Liver Cirrhosis with Nosocomial Infections? 　　【Abstract】Objective：To analysis pathogens distribution and antimicrobial drug use of chronic hepatitis and liver cirrhosis patients with nosocomial infection,to explore the rationality use of antibiotic；Methods：There was a retrospective analysis of 138 chronic hepatitis and liver cirrhosis patients with nosocomial infection of our hospital from January 2007 to March 2011,a reasonable evaluation was used in the main pathogen distribution, antimicrobial drug use; Results: Abdominal cavity,respiratory tract,blood,bile and urinary system were prone to bacterial infections in chronic hepatitis and liver cirrhosis patients,the respiratory tract was predominantly with Granr positive bacteria,while the others tract with Granr negative bacteria;the main antibiotics were quinolones,the enzyme inhibitor combined and the third-generation cephalosporins,combined antibiotic treatment was used while treating with basic liver protection and nutritional support. Conclusion: Chronic hepatitis and liver cirrhosis patients were prone to nosocomial infections,the medical staff should try to avoid violating the principle of sterile in clinical operations in order to reduce the incidence of nosocomial infections, the antibiotics should be used reasonably according to the results of drug sensitivity test in clinic . ? 　　【Key words】Chronic Hepatitis; Liver Cirrhosis; Nosocomial Infections; Antibiotic 　　 慢性肝炎肝硬化患者由于肝脏功能