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目的探讨重型肝炎合并革兰阴性菌感染的预后及影响因素,为有效防治提供指导。方法回顾性分析2004年1月—2006年6月我院住院的重型病毒性肝炎合并革兰阴性菌感染220例的预后,以及性别、年龄、肝炎型别、各种其他合并症、感染部位及细菌类型对预后的影响。结果重型肝炎合并革兰阴性菌感染占总体细菌感染的79.1%,总病死率为55.6%。年龄大于50岁者病死率更高;而急性、亚急性和慢性重型肝炎合并革兰阴性菌感染患者的病死率差异无统计学意义;血液感染的病死率高于呼吸道感染的病死率;大肠埃希菌的病死率明显高于克雷伯菌属及铜绿假单胞菌。结论重型肝炎合并革兰阴性菌感染的预后较差,应高度重视高危人群,积极治疗以提高生存率。
Objective To investigate the prognosis and influencing factors of severe hepatitis with gram-negative bacteria infection and provide guidance for effective prevention and treatment. Methods A retrospective analysis was performed on the prognosis of 220 cases of severe viral hepatitis with gram-negative bacteria admitted to our hospital from January 2004 to June 2006, as well as the gender, age, type of hepatitis, various other comorbidities, Effect of Bacterial Type on Prognosis. Results Severe hepatitis with gram-negative bacteria infection accounted for 79.1% of the total bacterial infection, the total case fatality rate was 55.6%. The mortality rate was higher in patients over 50 years of age. However, there was no significant difference in the mortality rate between acute, subacute and chronic severe hepatitis patients with Gram-negative bacteria infection. The mortality rate of blood infection was higher than that of respiratory infection. Fusarium bacteria mortality was significantly higher than Klebsiella and Pseudomonas aeruginosa. Conclusions The prognosis of severe hepatitis with gram-negative bacteria infection is poor. High-risk population should be highly valued and active treatment should be taken to improve the survival rate.