论文部分内容阅读
目的探讨慢性重型病毒性肝炎患者严重感染与预后的关系。方法回顾性调查慢性重型病毒性肝炎住院患者101例。按是否存在严重感染分为感染组与非感染组;同时按不同预后分为存活组与死亡组。比较感染组与非感染组之间肝肾功能、PTA、血常规、死亡率差异;比较存活组与死亡组之间感染率、血白细胞数差异。结果重型肝炎感染组患者血清TBIL、Cr高于非感染组患者(P值分别为0.013、<0.001),感染组患者血清PTA低于非感染组患者(P=0.001),差异有统计学意义;感染组患者死亡率(72.7%)高于非感染组患者死亡率(23.9%),差异有统计学意义(P<0.001);重型肝炎死亡组患者严重感染率(78.4%)、肺部感染率(49.1%)高于存活组患者(P值分别为<0.001、0.002),死亡组患者血白细胞数高于存活组患者,差异有统计学意义(P<0.001)。结论严重感染加重重型肝炎患者肝功能损害,增加其病死率。在临床上要合理使用抗菌素,加强各种感染的防控,以改善重型肝炎患者预后,提高其抢救成功率与治愈率。
Objective To investigate the relationship between severe infection and prognosis in patients with chronic severe viral hepatitis. Methods A retrospective survey of 101 cases of hospitalized patients with chronic severe viral hepatitis. According to whether there is a serious infection divided into infection group and non-infected group; according to different prognosis is divided into survival group and death group. The differences of liver and kidney function, PTA, blood routine and mortality between infected group and non-infected group were compared. The infection rate and the number of white blood cells were compared between survival group and death group. Results Serum levels of TBIL and Cr in patients with severe hepatitis were significantly higher than those in non - infected patients (P = 0.013, <0.001, respectively). Serum PTA was lower in infected patients than in non - infected patients (P = 0.001) The infection rate (72.7%) was higher than that in non-infection group (23.9%) (P <0.001). The severe infection rate in severe hepatitis death group (78.4%) and lung infection rate (49.1%) were higher than those in survivors (P <0.001 and 0.002, respectively). The number of blood leukocytes in death group was higher than that in survivors, the difference was statistically significant (P <0.001). Conclusions Severe infection aggravates hepatic dysfunction in patients with severe hepatitis and increases its mortality. In the clinical rational use of antibiotics to enhance the prevention and control of various infections to improve the prognosis of patients with severe hepatitis and improve the success rate of rescue and cure.