本文選題：肝硬化　切入點：失代償期　出處：《中華醫(yī)院感染學(xué)雜志》2017年19期 　論文類型：期刊論文

【摘要】：目的研究肝硬化失代償期患者并發(fā)血流感染的病原學(xué)特點及預(yù)后。方法選取于2010年2月-2016年8月醫(yī)院收治的肝硬化失代償期合并血流感染的患者89例作為觀察組,提取患者血液標本進行細菌培養(yǎng),對結(jié)果進行病原學(xué)分析和藥敏實驗分析;另選取同期的肝硬化失代償期無感染患者89例作為對照組,通過肝功能檢測,對兩組患者的預(yù)后進行對比。結(jié)果 89例觀察組患者的血液標本中,共分離出致病菌152株,其中革蘭陰性菌60株占39.47%;革蘭氏陽性菌92株占60.53%;藥敏結(jié)果顯示,表皮葡萄球菌對紅霉素、青霉素等具有較強的耐藥性,金黃色葡萄球菌對青霉素、阿奇霉素等具有較強耐藥性,均對替考拉林、萬古霉素等具有較強的敏感性;大腸埃希菌及肺炎克雷伯菌對磺胺甲VA唑/甲氧芐啶、阿莫西林等具有較強耐藥性,而對頭孢哌酮舒巴坦、派拉西林他唑巴坦等具有較強敏感性;肝功能檢測結(jié)果顯示,觀察組總膽紅素、凝血酶原時間、白蛋白分別為(103.3±53.4)μmol/L、(21.9±9.4)s、(27.6±10.8)g/L。對照組為(81.3±54.4)μmol/L、(16.8±10.2)s、(33.8±10.7)g/L,兩組的各項數(shù)據(jù)之間的差異均具有統(tǒng)計學(xué)意義(P均0.05)。結(jié)論對于肝硬化失代償期患者,其合并血流感染具有交叉耐藥和多藥耐藥的特點;相比于無感染的患者,并發(fā)血流感染的患者預(yù)后更差。
[Abstract]:Objective to study the etiological characteristics and prognosis of blood flow infection in decompensated patients with cirrhosis. Methods 89 patients with decompensated cirrhosis complicated with blood flow infection were selected from February 2010 to August 2016 as the observation group. The blood samples of the patients were extracted for bacterial culture, the results were analyzed by etiology and drug sensitivity test, 89 patients with no infection in decompensated stage of cirrhosis were selected as the control group, and the liver function was measured. Results 152 strains of pathogenic bacteria were isolated from the blood samples of 89 patients in the observation group, of which 60 were Gram-negative bacteria (39.47g), 92 Gram-positive bacteria (60.53). Staphylococcus epidermidis has strong resistance to erythromycin and penicillin, Staphylococcus aureus has strong resistance to penicillin and azithromycin, all have strong sensitivity to teicoplanin and vancomycin. Escherichia coli and Klebsiella pneumoniae have strong resistance to sulfamethazol / trimethoprim and amoxicillin, but to cefoperazone sulbactam and paracillin tazobactam. The total bilirubin, prothrombin time and albumin were 103.3 鹵53.4 渭 mol / L and 27.6 鹵10.8 渭 mol / L 路L ~ (-1) 路L ~ (-1) respectively in the observation group and the control group were 81.3 鹵54.4 渭 mol / L and 16.8 鹵10.2 鹵10.7 g / L, respectively. The difference between the two groups was statistically significant (P < 0.05). It has the characteristics of cross drug resistance and multi-drug resistance, and the prognosis of patients complicated with blood flow infection is worse than that of non-infection patients.
【作者單位】： 海南醫(yī)學(xué)院第二附屬醫(yī)院消化內(nèi)科;
【基金】：海南省自然科學(xué)基金資助項目(309118)
【分類號】：R575.2

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