论文部分内容阅读
目的探讨肝硬化患者合并感染性休克的临床特征及预后,为早期预防和控制肝硬化患者感染性休克及提高患者的生存率提供科学依据。方法回顾性分析2013年1-12月527例肝硬化患者并发感染性休克86例的临床资料,探讨肝硬化患者合并感染性休克的临床特征及预后,总结应对策略。结果 527例肝硬化患者发生感染性休克86例,发生率为16.32%;其中未发生感染性休克的441例患者死亡10例,病死率为2.27%,发生感染性休克的86例患者死亡9例,病死率为10.47%;86例肝硬化患者发生感染部位主要为肺部感染38例占44.19%、腹腔及肠道感染27例占31.39%;送检标本分离出病原菌75株,革兰阴性杆菌41株占54.67%、革兰阳性球菌14株占18.67%、真菌20株占26.66%,肝硬化患者发生感染性休克的危险因素为年龄、血清白蛋白、预防性应用抗菌药物、消化道出血、肝性脑病、住院时间。结论根据肝硬化患者合并感染性休克的临床特征,并针对危险因素给予应对策略,对降低肝硬化患者感染性休克有重要的意义,可改善患者预后。
Objective To investigate the clinical characteristics and prognosis of patients with cirrhosis complicated with septic shock and provide a scientific basis for early prevention and control of septic shock in patients with cirrhosis and improve the survival rate of patients with cirrhosis. Methods The clinical data of 527 patients with cirrhosis complicated with septic shock from January 2013 to January 2013 were retrospectively analyzed. The clinical features and prognosis of patients with cirrhosis complicated with septic shock were summarized. The coping strategies were summarized. Results A total of 527 cases of septic cirrhosis occurred in 86 patients (16.32%). Among 441 patients without septic shock, 10 died and the case fatality rate was 2.27%. Ninety-seven patients died of septic shock in 86 patients , And the case fatality rate was 10.47%. Among the 86 patients with cirrhosis, 38 were pulmonary infection, accounting for 44.19%, 27 were abdominal and intestinal infection, accounting for 31.39% of the total. Seventy-five pathogenic bacteria 41 strains accounted for 54.67%, 14 strains of Gram-positive cocci accounted for 18.67% and 20 strains accounted for 26.66%. The risk factors for septic shock in patients with cirrhosis were age, serum albumin, prophylactic antibiotics, gastrointestinal bleeding, Hepatic encephalopathy, hospital stay. Conclusion According to the clinical characteristics of patients with cirrhosis combined with septic shock, and to deal with risk factors to deal with strategies to reduce septic shock in patients with cirrhosis of great significance, can improve the prognosis of patients.