本文選題：失代償期肝硬化 + 預防性抗生素��； 參考：《福建醫(yī)科大學》2014年碩士論文

【摘要】：目的:探討預防性抗生素治療對失代償期肝硬化合并肺部CT炎性改變的影響及相關因素分析。 方法:回顧性分析2008年1月~2013年9月失代償期肝硬化合并肺部CT炎性改變的患者，其中常規(guī)治療同時接受預防性抗生素治療的患者（治療組），僅常規(guī)治療、未接受預防性抗生素治療的患者（對照組），比較兩組Child-Pugh評分、感染率等，并按年齡、性別、Child-pugh分級（B級：7-9分、C級：10-15分1)1:1的比例配對，比較肺部感染的發(fā)生率，分析其影響因素。采用SPSS13.0軟件進行統(tǒng)計分析，P0.05表示差異有統(tǒng)計學意義。 結果:根據納入與排除標準，本研究共入組患者105例，其中治療組35例，對照組70例。（1）兩組在年齡、性別等方面無統(tǒng)計學差異（P均＞0.05）；（2)住院期間出現肺部感染25例，總感染率23.8%（治療組8.6%，對照組31.4%），兩組肺部感染發(fā)生率的差異有統(tǒng)計學意義(χ2=6.720，P=0.010)；(3)在Child-Pugh B/C級、INR或1.5、PLT或98×109/L、TBIL或54.4umol/L亞組分層中，顯示在Child-Pugh C級、INR1.5、PLT98×109/L、TBIL54.4umol/L分層患者,治療組出現肺部感染率明顯低于對照組，差異有統(tǒng)計學意義（P均0.05）；(4)治療組與對照組間平均住院日比較差異無統(tǒng)計學意義（P=0.587）,但在感染組與非感染組間平均住院日比較差異有統(tǒng)計學意義（P=0.022）；（5）logistic多因素分析結果提示預防性抗生素治療是失代償期肝硬化合并肺部CT炎性改變患者進展肺部感染的獨立保護因素為：RR值0.095（95%CI：0.018~0.504，P=0.006）；（6）logistic多因素分析結果提示血清血乳酸是感染的重要相關因素：RR值0.328（95%CI：0.110~0.978，P=0.045）。 結論:（1）失代償期肝硬化合并肺部CT炎性改變患者預防性抗生素治療可有效減少肺部感染發(fā)生率、減少平均住院日；（2）若存在Child-pugh C級、INR1.5、PLT98×109/L及TBIL54.4umol/L其中一項以上者，宜盡早行預防性抗生素治療，以降低住院期間肺部感染的發(fā)生率。
[Abstract]:Objective: to investigate the effect of prophylactic antibiotic therapy on pulmonary CT inflammatory changes in decompensated cirrhosis. Methods: the patients with decompensated cirrhosis complicated with pulmonary CT inflammatory changes from January 2008 to September 2013 were retrospectively analyzed. Patients who were not treated with prophylactic antibiotics (control group, comparison of Child-Pugh score, infection rate, etc.) were matched according to age, Child-pugh grade B: 7-9, C: 10-15, 1: 1: 1. The incidence of pulmonary infection was compared and the influencing factors were analyzed. Using SPSS13.0 software to carry on statistical analysis P 0.05 indicated that the difference was statistically significant. Results: according to the criteria of inclusion and exclusion, there were 105 patients in this study, including 35 cases in the treatment group and 70 cases in the control group. There was no significant difference in age, sex and other aspects between the two groups (P > 0.05). The total infection rate was 23.8cm (the treatment group was 8.6 and the control group was 31.4g), and the difference between the two groups was statistically significant (蠂 ~ 2 ~ (6.720) P ~ (0.010) in the Child-Pugh B / C grade INR or 1.5 脳 10 ~ (9) L% TBIL or 98 脳 10 ~ (9) L / L TBIL or 54.4umol/L subgroup, it was shown in the Child-Pugh C grade INR 1.5 PLT98 脳 10 ~ 9% TBI 54.4 umolol / L stratification. The pulmonary infection rate in the treatment group was significantly lower than that in the control group. There was no significant difference in average hospitalization days between the treatment group and the control group, but there was significant difference between the infection group and the non-infection group. The results showed that prophylactic antibiotic therapy was an independent protective factor for progressive pulmonary infection in patients with decompensated cirrhosis with pulmonary CT inflammatory changes. The results of multivariate analysis indicated that the ratio of blood lactate in serum was an important factor related to infection: RR: 0.32895CIW 0.1100.978CIW 0.1100.978F0. 0455.The results of logistic multivariate analysis showed that the ratio of serum lactate was 0.32895CIW 0.1100.978and P0.045. Conclusion the prophylactic antibiotic therapy for decompensated cirrhosis with pulmonary CT inflammatory changes can effectively reduce the incidence of pulmonary infection and reduce the average hospitalization days. If there is Child-pugh C grade INR1.5 PLT98 脳 109 / L and one or more of TBIL54.4umol/L, Prophylactic antibiotics should be given as early as possible to reduce the incidence of pulmonary infection during hospitalization.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R575.2

【參考文獻】

相關期刊論文 前2條

1 焦建中,彌建平,焦建新,吳永勝;慢性肝病醫(yī)院感染危險因素分析[J];中華醫(yī)院感染學雜志;2001年05期

2 熊英;;重癥肝炎并發(fā)醫(yī)院感染的危險因素分析[J];中華醫(yī)院感染學雜志;2011年22期

，

本文編號：1906604