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目的 了解肝硬化上消化道出血合并细菌感染对再出血率及 4周病死率的影响。方法 观察 70例入院前 1周未使用抗菌药物的肝硬化上消化道出血患者 ,分别于入院后 1、2、3、5与 7天进行血液、尿液、腹水细菌培养 ,采用Child积分评价肝功能损害程度。结果 2 0例 (2 8 6% )在入院 7天内发生 3 6例次细菌感染 ,感染组Child积分明显高于非感染组 (P <0 .0 1) ,再出血发生率 (5 0 %比 10 % ;P <0 .0 1) ,4周病死率 (3 5 %比 13 .3 % ;P <0 .0 1)明显上升。结论 肝硬化患者发生细菌感染时会明显增加肝脏损害程度 ,并可能增加近期死亡率 ,应引起临床足够重视
Objective To investigate the effect of upper gastrointestinal bleeding combined with bacterial infection on the rate of rebleeding and 4-week mortality in cirrhotic patients. Methods 70 patients with cirrhosis and upper gastrointestinal bleeding who did not use antibiotics 1 week before admission were enrolled. Bacterial culture of blood, urine and ascites were performed on 1, 2, 3, 5 and 7 days after admission. Functional impairment. Results Twenty-six bacterial infections occurred in 20 patients (286%) within 7 days after admission. The score of Child in the infected group was significantly higher than that in the non-infected group (P <0.01), and the rate of rebleeding 10%; P <0.01). The 4-week mortality rate (35% vs 13.3%; P <0.01) increased significantly. Conclusions Bacterial infection in patients with cirrhosis can significantly increase the degree of liver damage, and may increase the recent mortality, should cause enough attention in clinical