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目的分析肝硬化患者发生肺部感染的相关因素,为临床治疗提供依据。方法收集感染患者的一般资料、腹水情况、病原菌感染、基础疾病、抗菌药物使用情况等。用SPSS15.0进行统计分析,采用χ2检验分析肝硬化患者发生肺部感染的相关因素。结果 1 184例肝硬化患者中出现肺部感染142例,感染率为11.99%,其中男性95例,女性47例;乙肝性肝硬化98例,乙醇性肝硬化24例,原发性胆汁性肝硬化10例。142例肺部感染肝硬化患者痰液标本中检出病原菌157株,其中大肠埃希菌46株,肺炎克雷伯菌27株,金黄色葡萄球菌22株,铜绿假单胞菌14株,表皮葡萄球菌13株,肺炎链球菌11株,白色假丝酵母菌9株,其他病原菌15株。142例肝硬化肺部感染患者发生肺部感染常伴有不同的临床特征,其中发热患者占19.01%,肺部浸润患者占14.79%。肝硬化患者的性别和腹水有无情况与感染发生无关,差异无统计学意义(P均>0.05);而肝硬化患者的年龄、住院时间、基础疾病有无、使用抗菌药物是否合理、是否接受侵入性操作与其肺部感染发生相关,差异有统计学意义(P均<0.05)。结论不同类型的肝硬化患者均有肺部感染发生,患者感染病原菌类型以革兰阴性为主。感染患者常伴有发热、肺部浸润、呼吸衰竭等临床症状,且感染发生与年龄、住院时间、基础疾病、使用抗菌药物以及侵入性操作相关。
Objective To analyze the related factors of pulmonary infection in patients with cirrhosis and provide basis for clinical treatment. Methods Collecting general information of infected patients, the situation of ascites, pathogen infection, underlying diseases, antimicrobial use and so on. SPSS15.0 statistical analysis, the use of χ2 test analysis of the incidence of pulmonary infection in patients with cirrhosis of the relevant factors. Results A total of 142 cases of pulmonary infection were found in 1 184 cases of patients with cirrhosis, the infection rate was 11.99%, including 95 males and 47 females; 98 cases of hepatitis B cirrhosis, 24 cases of alcoholic cirrhosis, primary biliary liver Sclerosis in 10 cases. A total of 157 pathogens were detected in sputum of 142 patients with pulmonary infection of cirrhosis, including 46 strains of Escherichia coli, 27 strains of Klebsiella pneumoniae, 22 strains of Staphylococcus aureus, 14 strains of Pseudomonas aeruginosa, Staphylococcus 13, Streptococcus pneumoniae 11, Candida albicans 9, 15 other pathogens. 142 cases of pulmonary infection in patients with cirrhosis of the lung infection often accompanied by different clinical features, of which 19.01% of patients with fever, pulmonary infiltration patients accounted for 14.79%. There was no significant difference in gender and ascites between patients with cirrhosis and those without infection (P> 0.05). However, the age of patients with cirrhosis, length of hospital stay, presence or absence of underlying diseases, use of antimicrobial agents was reasonable, Invasive operation and its occurrence of pulmonary infection, the difference was statistically significant (P all <0.05). Conclusion Different types of patients with cirrhosis have pulmonary infection, and the type of pathogens in patients with infection is mainly Gram-negative. Infected patients are often accompanied by fever, pulmonary infiltrates, respiratory failure and other clinical symptoms, and the incidence of infection and age, length of stay, underlying diseases, the use of antibiotics and invasive operations related.