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目的重型病毒性肝炎患者肝功能严重障碍,免疫功能低下,易伴发医院真菌感染,死亡率较高,制定有效的预防措施极为重要。方法重型病毒性肝炎患者研究组与对照组各115例,对合并医院真菌感染的诱发因素、真菌种类、临床特点与相关因素的关系进行分析研究。结果重型病毒性肝炎医院真菌感染部位以腹腔感染为主(40.9%),其次是胃肠道,可能与不合理的侵入性操作有关;相关因素中以应用抗生素、激素为主,研究组与对照组有统计学意义(P<0.01);真菌感染前多有细菌感染,均接受2种以上广谱抗生素治疗及其预防细菌感染,平均3种,最多应用5种,疗程平均(35±12.2)d,疗程越长,真菌感染率越高。结论不合理的抗生素应用易造成菌群失调,激素的应用更造成重肝患者免疫力下降,引起真菌感染,不规范的侵入性技术操作(腹腔穿刺)是腹腔感染发生率高的原因。
Purpose Severe hepatic dysfunction, immunocompromised patients with severe viral hepatitis may be associated with fungal infections in the hospital, with high mortality rates and the development of effective preventive measures. Methods A total of 115 patients with severe viral hepatitis in study group and control group were included in this study. The relationship between the factors causing fungal infection, fungal species, clinical features and related factors were analyzed. Results The majority of hospital-acquired fungal infections in patients with severe viral hepatitis were abdominal infections (40.9%), followed by the gastrointestinal tract, which may be related to unreasonable invasive procedures. Among the relevant factors, antibiotics and hormones were the main factors. Group had statistical significance (P <0.01). Before the fungal infection, there were more bacterial infections, which were treated with two or more kinds of broad-spectrum antibiotics and the prevention of bacterial infection. The average number of the three groups was 5 and the average was 5 ± 12.2 d, longer course of treatment, the higher the fungal infection rate. Conclusion The application of unreasonable antibiotics can easily lead to flora imbalance. The application of hormones also causes the immunity of patients with severe hepatitis to decline, causing fungal infection. Non-standard invasive technique (abdominal puncture) is the reason of high incidence of abdominal infection.