中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
9期
809-812
,共4页
杨美荣%宋洁%张嵩%张海霞%王英曼%闫振宇
楊美榮%宋潔%張嵩%張海霞%王英曼%閆振宇
양미영%송길%장숭%장해하%왕영만%염진우
慢性乙型肝炎病毒感染%院内感染%影响因素
慢性乙型肝炎病毒感染%院內感染%影響因素
만성을형간염병독감염%원내감염%영향인소
Chronic hepatitis B virus infection%Hospital acquired infections%Effective factors
目的 探讨引起慢性乙型肝炎病毒(HBV)感染患者发生医院感染的相关因素.方法 对2009年7月至2014年6月470例慢性HBV感染合并医院感染患者的临床资料进行回顾性分析,对引起医院感染的危险因素进行病例对照研究.结果 医院感染发生率29.1％(137/470).多因素分析影响感染因素如下:住院时间(OR=27.824,95％CI7.187～98.386)、侵入性操作史(OR=17.201,95％ CI4.245～71.303)、并发症(OR=2.138,95％ CI1.030～4.377)、预防性应用抗生素(OR=2.741,95％ CI1.816～4.010)、饮酒史(OR=34.248,95％ CI 13.045 ～ 82.328)、血清白蛋白低(OR=17.258,95％ CI6.242～53.162)、PCR-HBVDNA定量(OR=4.859,95％CI3.214～7.625)、白细胞低(OR=4.271,95％ CI1.520～ 12.157)、胆碱酯酶低(OR=2.761,95％ CI 1.523～3.787)、抗病毒药物(OR=0.128,95％ CI0.041 ～0.375)(P均＜0.05).结论 引起慢性HBV感染患者并发医院感染的危险因素较多,住院时间、侵入性操作史、出现并发症、白细胞低、低蛋白血症、胆碱酯酶低下、预防性应用抗生素、应用激素、高PCR-HBVDNA定量、饮酒是影响慢性HBV感染患者发生院内感染的重要危险因素;应用抗病毒药物是有效预防慢性HBV感染患者发生院内感染的保护因素.
目的 探討引起慢性乙型肝炎病毒(HBV)感染患者髮生醫院感染的相關因素.方法 對2009年7月至2014年6月470例慢性HBV感染閤併醫院感染患者的臨床資料進行迴顧性分析,對引起醫院感染的危險因素進行病例對照研究.結果 醫院感染髮生率29.1％(137/470).多因素分析影響感染因素如下:住院時間(OR=27.824,95％CI7.187～98.386)、侵入性操作史(OR=17.201,95％ CI4.245～71.303)、併髮癥(OR=2.138,95％ CI1.030～4.377)、預防性應用抗生素(OR=2.741,95％ CI1.816～4.010)、飲酒史(OR=34.248,95％ CI 13.045 ～ 82.328)、血清白蛋白低(OR=17.258,95％ CI6.242～53.162)、PCR-HBVDNA定量(OR=4.859,95％CI3.214～7.625)、白細胞低(OR=4.271,95％ CI1.520～ 12.157)、膽堿酯酶低(OR=2.761,95％ CI 1.523～3.787)、抗病毒藥物(OR=0.128,95％ CI0.041 ～0.375)(P均＜0.05).結論 引起慢性HBV感染患者併髮醫院感染的危險因素較多,住院時間、侵入性操作史、齣現併髮癥、白細胞低、低蛋白血癥、膽堿酯酶低下、預防性應用抗生素、應用激素、高PCR-HBVDNA定量、飲酒是影響慢性HBV感染患者髮生院內感染的重要危險因素;應用抗病毒藥物是有效預防慢性HBV感染患者髮生院內感染的保護因素.
목적 탐토인기만성을형간염병독(HBV)감염환자발생의원감염적상관인소.방법 대2009년7월지2014년6월470례만성HBV감염합병의원감염환자적림상자료진행회고성분석,대인기의원감염적위험인소진행병례대조연구.결과 의원감염발생솔29.1％(137/470).다인소분석영향감염인소여하:주원시간(OR=27.824,95％CI7.187～98.386)、침입성조작사(OR=17.201,95％ CI4.245～71.303)、병발증(OR=2.138,95％ CI1.030～4.377)、예방성응용항생소(OR=2.741,95％ CI1.816～4.010)、음주사(OR=34.248,95％ CI 13.045 ～ 82.328)、혈청백단백저(OR=17.258,95％ CI6.242～53.162)、PCR-HBVDNA정량(OR=4.859,95％CI3.214～7.625)、백세포저(OR=4.271,95％ CI1.520～ 12.157)、담감지매저(OR=2.761,95％ CI 1.523～3.787)、항병독약물(OR=0.128,95％ CI0.041 ～0.375)(P균＜0.05).결론 인기만성HBV감염환자병발의원감염적위험인소교다,주원시간、침입성조작사、출현병발증、백세포저、저단백혈증、담감지매저하、예방성응용항생소、응용격소、고PCR-HBVDNA정량、음주시영향만성HBV감염환자발생원내감염적중요위험인소;응용항병독약물시유효예방만성HBV감염환자발생원내감염적보호인소.
Objective To investigate hospital acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From July 2008 to June 2013,the clinical data of 470 cases of hospital acquired infections patients with chronic hepatitis B virus (HBV) infection were retrospectively analyzed by case-control study for the effective factors.Results Hospital acquired rate was 29.1％ (137/470).By logistic regression analysis,the effective factors were length of stay (OR =27.824,95％ CI 7.187-98.386),invasive operation (OR =17.201,95％ CI 4.245-71.303),a complication (OR =2.138,95％ CI 1.030-4.377),preventive use of antibiotics(OR =2.741,95％CI 1.816-4.010),drinking history(OR=34.248,95％CI 13.045-82.328),serum albumin(OR =17.258,95％ CI 6.242-53.162),quantitative PCR-HBVDNA (OR =4.859,95％ CI 3.214 -7.625),white blood cell (OR =4.271,95 ％ CI 1.520-12.157),c holinesterase (OR =2.761,95 ％ CI 1.523 -3.787) and anti virus medicine(OR=0.128,95％CI 0.041-0.375) (P＜0.05).Conclusion This study shows that length of stay,invasive operation history,complications,low white blood cell,low serum protein,low cholinesterase,the prophylactic use of antibiotics,hormone,high PCR-HBVDNA quantitative and drinking are the important risk of hospital acquired infections infection factors of patients of impact chronic HBV infection.Applications of antiviral drugs are effective in the prevention of chronic HBV infection protection factors of hospital acquired infections infection patients.
