Treatment of postoperative infectious complications in patients with human immunodef iciency virus i

来源 :World Journal of Emergency Medicine | 被引量 : 0次 | 上传用户:plxu
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodef iciency virus(HIV)-infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics.METHODS: This retrospective study consisted of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012. The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection(SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotics until the infection was controlled. Antiretroviral therapy(ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells/μL. For those patients whose preoperative CD4 count was <200 cells/μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic agents controlling Pneumocystis carinii pneumonia and fungal infection.RESULTS: A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4/CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cell/μL, anemia, a postoperative CD4 count <200 cell/μL or albumin levels <35 g/L were correlated with a higher rate of perioperative infection. There was a signif icant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical incision was 2% and in those with type II surgical incision was 38%. All the patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis.CONCLUSIONS: HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients. BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodeficiency virus (HIV) -infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics. METHODS: This retrospective study consisting of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012 The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection (SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotic Antiretroviral therapy (ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells / μL. For those patients whose preoperative CD4 count was <200 cells / μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic Of agents controlling Pneumocystis carinii pneumonia and fungal infection. RESULTS: A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4 / CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cell / μL, anemia, a postoperative CD4 count <200 cell / μL or albumin levels <35 g / L were correlated with a higher rate of perioperative infection. There was a signif icant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical in cision was 2% and in those with type II surgical incision was 38%. All the patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis. CONCLUSIONS: HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.
其他文献
The present short review aims to give an overview of the most recent developments in fluorescence microscopy and its applications in biomedical sciences. Apart
南八家乡清财工作见实效抚顺市农牧业局合作经济处杨松芝)按照抚顺市政府《关于开展村级财务清理专项执法监察工作的实施方法》精神要求,清原县在南八家乡开展清理整顿农村财务
马来西亚位于东南亚,地处太平洋和印度洋之间。全境被南中国海分成东马来西亚和西马来西亚两部分。北与泰国接壤(rang),西濒(bin)马六甲海峡,东临南中国海,南面隔着柔佛海峡
龙门口水库始建于1958年。库中不乏大鱼,常有5~8千克的大鱼被钓获。今年8月28日,星期六,天气阴转多云,气温20~28℃。下午3时30分,我和两位钓友兴致勃勃地来到该库垂钓。我采用
中国社科院日前发布的《中国经济形势分析与预测2003年秋季报告》对今年的宏观经济运行做了乐观预测,预计2003年GDP增长率将达8.2%左右,如果2004年无重大突发性不利因素,GDP
澳大利亚,听到这个名字,涌入眼前的会是什么?是连绵的山丘,成群的牛羊,纯争的山河,还是满车的矿产?一个独立于世的神秘之处,在世界的另一个半球,自成一天地,带着几分神秘和未
“长”有两个读音,一个是cháng,一个是zhǎng。鲁迅在他的《从百草园到三味书屋》《为了忘却的记念》《阿长与》等作品中,多次提到自己的乳母“长妈妈”。中学语文课本的注
早就听说宁夏是塞上江南,黄河自流灌区有七十二连湖,湖湖鱼虾丰盈,其中一湖最为出名,那便是位于首府银川市北面70余公里处的沙湖。 在亲友的帮助下,4月16日我终于投奔到了居
山东省委书记张高丽: 中国要发展得更快,需要高度重视两个方面:一是发展社会主义市场经济。必须依照市场经济的规律办事,这方面我们还有很长的路要走,包括借鉴外国的经验等
为辨析《内经》、《伤寒论》“癃”、“淋”两字音义异同,在运用音韵学方法考证有关古代文献及避讳用法的基础上,认为《内经》的“癃”系避汉殇帝刘隆之讳而改为《伤寒论》的