肝硬化上消化道出血预防性抗感染治疗失败的影响因素

李孝楼; 陈明胜; 甘巧蓉; 江晓燕; 陈立

doi:10.3969/j.issn.1001-5256.2016.02.018

肝硬化上消化道出血预防性抗感染治疗失败的影响因素

DOI: 10.3969/j.issn.1001-5256.2016.02.018

福建医科大学孟超肝胆医院福州市传染病医院

基金项目:

福州市卫生系统科技计划项目(2013-S-wq14;2013-S-W10)；

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2015-07-15
- 出版日期: 2016-02-20

Risk factors for antibiotic prophylaxis failure in patients with liver cirrhosis and upper gastrointestinal bleeding

Mengchao Hepatobiliary Hospital,Fujian Medical University

Research funding:

摘要

摘要: 目的探讨肝硬化上消化道出血患者接受预防性抗感染治疗失败的影响因素。方法回顾性分析2011年1月-2014年6月福建医科大学孟超肝胆医院收治的肝硬化上消化道出血患者82例,所有患者均接受三代头孢菌素预防性抗感染治疗7 d,观察抗感染治疗2周内的疗效,比较分析预防有效组和无效组之间临床特征的差异,计量资料组间比较采用t检验,计数资料组间比较采用χ2检验或Wilcoxon秩和检验。应用Logistic回归分析导致预防性抗感染失败的影响因素。结果 38例（46.4%）患者发生继发感染,预防有效组和预防无效组在凝血酶原时间、入住ICU的比例、入住ICU时间、接受深静脉穿刺的比例、Child-Pugh分级和Child-Pugh评分上比较差异均有统计学意义（P值均<0.05）。Child-Pugh分级和入住ICU是预防性抗生素治疗失败的独立危险因素,比值比分别为2.455[95%可信区间（95%CI）:1.015.97,P=0.048]和4.12（95%CI:1.3212.83,P=0.015）。结论三代头孢菌素预防性抗感染治疗失败率较高,入住ICU...
- 肝硬化 /
- 胃肠出血 /
- 头孢菌素类 /
- 治疗 /
- 危险因素
Abstract: Objective To investigate the risk factors for antibiotic prophylaxis failure in patients with liver cirrhosis and upper gastrointestinal bleeding. Methods Eighty- two patients with liver cirrhosis and upper gastrointestinal bleeding who were admitted to our hospital from January 2011 to June 2014 were analyzed retrospectively. All patients received third- generation cephalosporins as the antibiotic prophylaxis for 7 days. The therapeutic effect of prophylaxis within two weeks was analyzed,and the clinical features were compared between prophylaxis response group and non- response group. The t- test or Mann- Whitney U test was applied for comparison of continuous data between groups,the chi- square test was applied for comparison of categorical data between groups,and the logistic regression analysis was applied to determine the risk factors for antibiotic prophylaxis failure. Results A total of 38 patients( 46. 4%) developed secondary infection.There were significant differences in prothrombin time,proportion of patients admitted to the intensive care unit( ICU),duration of ICU stay,proportion of patients who received deep venipuncture,Child- Pugh classification,and Child- Pugh score between the prophylaxis response group and non- response group( P < 0. 05). Child- Pugh classification( OR = 2. 455,95% CI: 1. 01- 5. 97,P = 0. 048) and admission to the ICU( OR = 4. 12,95% CI: 1. 32- 12. 83,P = 0. 015) were the independent risk factors for antibiotic prophylaxis failure.Conclusion Antibiotic prophylaxis with third- generation cephalosporins has a high failure rate,and admission to the ICU and a high Child- Pugh classification are the independent risk factors for antibiotic prophylaxis failure.
- liver cirrhosis /
- gastrointestinal hemorrhage /
- cephalosporins /
- therapy /
- risk factors

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参考文献(13)

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