目的　探讨医院感染对重型病毒性肝炎预后的影响。方法　对 1992年 1月～ 2 0 0 0年 3月间收治的 78例重型病毒性肝炎患者进行回顾性调查分析。结果　 78例重型肝炎患者并发医院感染有 38例 ,感染发生率为4 8.7% ,感染部位以腹腔、胃肠道、呼吸道占前 3位 ;G-杆菌 11株 (5 5 % ) ,真菌 5株 (2 5 % ) ,G+球菌 4株 (2 0 % ) ;并发医院感染的重型病毒性肝炎患者多器官衰竭的发生率为 94 .7% ,病死率为 6 8.4 % ,均明显高于无医院感染的重型病毒性肝炎患者 (P<0 .0 1)。结论　重型病毒性肝炎患者容易继发各种医院感染 ,影响预后。 Objective To investigate the influence of nosocomial infection on the prognosis of severe viral hepatitis. Methods A retrospective investigation was performed on 78 patients with severe viral hepatitis who were admitted between January 1992 and March 2000. Results Among the 78 patients with severe hepatitis, 38 cases were complicated with nosocomial infection, the infection rate was 47.7%. The infection sites were abdominal cavity, gastrointestinal tract and respiratory tract, the top three were G-bacilli 11 (5 5%) and fungi 5 (25%) and 4 strains of G + cocci (20%). The incidence of multiple organ failure in hospital-acquired severe viral hepatitis was 94.7% and the case fatality rate was 6 8.4%, which were significantly higher than those without hospital Infected patients with severe viral hepatitis (P <0.01). Conclusions Patients with severe viral hepatitis are prone to secondary to various hospital infections and affect the prognosis.