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目的探讨预防性应用抗菌药物降低老年患者肝硬化急性上消化道大出血医院感染的疗效,寻找预防医院感染的有效方法,以降低医院感染率。方法选取2012年4月-2014年4月73例老年肝硬化急性上消化道大出血患者为研究对象,随机分为治疗组37例和对照组36例,两组患者均予禁食、抗休克、扩充血容量、止血等常规治疗,治疗组患者在此基础上加用头孢哌酮/舒巴坦3.0g静脉滴注,至出血停止后7d;观察比较两组患者临床指标,数据采用SPSS 18.0进行统计分析。结果治疗组与对照组患者医院感染率分别为21.6%与47.2%,且治疗组发生各种感染率及混合感染率均明显低于对照组,差异有统计学意义(P<0.05);患者治疗有效率和病死率分别为78.4%和13.5%,对照组患者分别为55.6%和27.8%,治疗组均优于对照组,差异有统计学意义(P<0.05)。结论抗菌药物预防性应用可明显降低老年肝硬化急性上消化道大出血患者医院感染率和病死率,提高其生活质量,疗效肯定。
Objective To investigate the preventive effect of antimicrobial agents on nosocomial infection of cirrhotic patients with acute upper gastrointestinal bleeding in elderly patients and to find effective ways to prevent nosocomial infections so as to reduce the nosocomial infection rate. Methods From April 2012 to April 2014, 73 elderly patients with acute upper gastrointestinal bleeding due to cirrhosis were randomly divided into treatment group (37 cases) and control group (36 cases). Both groups were given fasting, anti-shock, Expansion of blood volume, bleeding and other conventional treatment, the treatment group patients on this basis plus cefoperazone / sulbactam 3.0g intravenous infusion to stop bleeding after 7d; clinical indicators of two groups were observed and compared using SPSS 18.0 data Statistical Analysis. Results The nosocomial infection rates in treatment group and control group were 21.6% and 47.2%, respectively, and the rates of infection and mixed infection in treatment group were significantly lower than those in control group (P <0.05) The effective rate and the mortality rate were 78.4% and 13.5% respectively, while those in the control group were 55.6% and 27.8% respectively. The treatment group was superior to the control group with statistically significant difference (P <0.05). Conclusion The prophylactic use of antimicrobial agents can significantly reduce nosocomial infection and mortality in patients with acute upper gastrointestinal bleeding due to cirrhosis and improve their quality of life.