人工肝治疗肝衰竭病人医院感染调查及危险因素分析

    Analysis of nosocomial infection and risk factors in patients with liver failure treated with artificial liver

    • 摘要:
      目的了解人工肝治疗肝衰竭病人发生医院感染的特点及其危险因素,为制定干预措施提供依据。
      方法回顾性收集接受人工肝治疗的207例肝衰竭病人临床资料和实验室检查结果,统计人工肝治疗肝衰竭病人发生医院感染的情况,采用单因素及二元logistic回归分析筛选其危险因素。
      结果207例人工肝治疗肝衰竭病人,发生医院感染46例,感染发生率为22.22%(46/207)。以呼吸道感染为主,占14.01%(29/207),其次是自发性腹膜炎4.83%(10/207)、血流感染1.93%(4/207)。46例病人各类标本中共分离出48株病原菌,其中革兰阳性菌占25.00%(12/48)、革兰阴性菌占56.25%(27/48)、真菌占18.75%(9/48)。logistic回归分析显示年龄≥60岁(OR=1.050, 95%CI: 1.014~1.087, P < 0.01)、合并糖尿病(OR=2.597, 95%CI: 1.171~5.763, P < 0.05)、导管留置时间(OR=1.456, 95%CI: 1.104~1.919, P < 0.01)、血浆白蛋白浓度(OR=0.871, 95%CI: 0.802~0.945, P < 0.01)及MELD评分(OR=1.156, 95%CI: 1.058~1.262, P < 0.01)是人工肝治疗肝衰竭病人发生医院感染的独立危险因素。
      结论人工肝治疗肝衰竭病人医院感染发生率较高,在临床治疗和护理过程中应关注危险因素,采取有效预防措施,以减少医院感染的发生。

       

      Abstract:
      ObjectiveTo investigate the characteristics and risk factors of nosocomial infection in patients with liver failure treated with artificial liver, so as to provide basis for the formulation of intervention measures.
      MethodsClinical data and laboratory test results of 207 patients with liver failure were retrospectively collected.The incidence of nosocomial infection in patients with liver failure treated with artificial liver was counted, and the risk factors were analyzed by univariate and binary logistic regression analylsis.
      ResultsAmong 207 patients with liver failure treated with artificial liver, 46 patients had nosocomial infection, and the infection rate was 22.22%.Respiratory tract infections 14.01%(29/207) was predominant, followed by spontaneous peritonitis 4.83% (10/207) and bloodstream infections 1.93% (4/207).A total of 48 pathogens were isolated from various specimens of 46 patients, including 12 strains (25.00%) of Gram-positive bacteria, 27 strains (56.25%) of Gram-negative bacteria, and 9 strains (18.75%) of fungi.Multivariate logistic regression analysis showed that advanced age (age ≥60 years) (OR=1.050, 95%CI: 1.014-1.087, P < 0.01), diabetes mellitus (OR=2.597, 95%CI: 1.171-5.763, P < 0.05), catheter indwelling time (OR=1.456, 95%CI: 1.104-1.919, P < 0.01), plasma albumin concentration (OR=0.871, 95%CI: 0.802-0.945, P < 0.01) and MELD score (OR=1.156, 95%CI: 1.058- 1.262, P < 0.01) were independent risk factors for nosocomial infection in patients with liver failure treated with artificial liver.
      ConclusionsThe incidence of nosocomial infection in patients with liver failure treated with artificial liver is high.In the process of clinical treatment and nursing, attention should be paid to risk factors, and effective preventive measures should be taken to reduce the occurrence of nosocomial infection.

       

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