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Results � 2 2.1 181 cirrhotic patients with the infection rate of 101 cases of infection. infection rate was 55.8%, 27.1% of nosocomial infection. � 2.2 infection sites were 101 cases of infection times for a total of 133 cases of infection occurred. 4 cases of which three infections, 24 cases of infection of two parts, one part of the remaining 73 cases of infection. By the frequency of infection sites were as follows : 59 cases of primary peritonitis time, 15 cases of intestinal infection. 12 cases of upper respiratory tract infection, bacteremia nine cases meeting, lung infection and pleurisy meeting of the eight cases. Biliary tract infection, urinary tract infection and oral infection five times, four cases of skin and soft tissue infections time, 3 cases of septic shock. � 2.3 incidence of infection-related factors causing infection and liver function 2.3.1 grades of Child - Section 101 cases of infection. A, B and C patients respectively 11 cases, 41 cases and 49 cases. 80 cases of non-infected group, A, B and C patients respectively 26 cases, 39 cases and 15 cases. Child-C infection in patients with cirrhosis group were significantly higher than non-infected patients. significant difference between the two groups (x2=22.03, 0.01) is shown in Table 1. � liver function Child-grade comparison group (X2) A B C Total infected groups of 11 (20. 6) 41 (44.6) 49 (35.7) 101 non-infected group, 26 (16.4) 39 (35.4 ) 15 (28.3) 81 Total 37 80 64 181 Note : Theoretical data for the number of brackets (T) 2.3.2 nosocomial infection and hospital stay time "in January. Ointment and "half of those on the incidence of nosocomial infection rates were 63.2%, 26.6%, 10.2%. Cirrhotic patients at the hospital, "hospital occurred in January were significantly higher than the chances of infection" in January (P <0.01) in Table 2. Nosocomial infections of the relationship between length of stay and hospital infection cases of infection "half 5 1 10.2% Ointment 3 26.6%, "January 31 63.2 2.3.3 nosocomial infections and 133 cases of invasive operation between infection , the number of patients with invasive operation in the first three places respectively : 25 cases of deep venous catheter infection received before the operation. 14 patients with abdominal paracentesis, four cases Thoracentesis. � add : 2.4 pathogenic bacteria has been detected in the culture of Escherichia coli bacteria are : (ascites); aeruginosa (ascites); Klebsiella foul nose (blood, phlegm, bedsore pus), fungal prima Sisha (blood jugular vein cannulation), grape skin bacteria (sputum), Candida albicans (sputum, feces throat), Rumsfeld Xidixi bacteria (sputum). Staphylococcal ears (urine). � 2.5 vesting who died 29 cases of infection occurred, the mortality rate for infected persons died in 2002 two cases did not occur. mortality rate of 2.5%. The remaining 72 cases were infected in pathogen detection based on the rational use of antibiotics and protective, and diuretic therapy, etc., maintain a clean mouth and skin care benefit under both improved infection control discharged The average hospital stay was 25.9 days for the few. No infection in the other 78 cases under treatment and care are reasonable discharged improved, the average length of stay was 16.5 days. Mortality was significantly higher than non-infected patients with cirrhosis infected. (X2=21.6 0.01) Table 3 � infected and non-infected group compared mortality improvement in the number of death cases Total number of infected cases, 29 (17.3) 72 (83.7) 101 non-infected group 2 (13.7) 78 ( 66.3) 80 Total 31 150 181 difference between the two groups is statistically significant

3 讨论
本组肝硬化患者感染发生率55.8%，肝硬化肝功能失代偿child—pugh C级患者合并感染者明显增多。院内

感染总发生例次率34.3%，住院时间超过1月者发生院人感染机会明显增加，住院期间由于诊冶需要而行各

种创伤性操作也增加了医源性感染的机会。肝硬化验室患者肠道内菌群上移，而小肠段肠壁较薄，门脉压

增高使肠壁淤血，淋巴流量增多，导致肠壁水肿，致使肠壁屏障被破坏〔3〕。肝硬化患者肝细胞坏死、

纤维化的同时，肝脏的单核—巨噬细胞系统功能亦显著受损，使来自肠腔的细菌不能被清除，易发生肠源

性感染。本资料已培养检测到的细菌以条件致病菌居多，治疗选用抗菌药物最多的是甲硝唑和头孢第三代

类。本组发生感染者病死率28.7％，明显高于无合并感染者的病死率2.5％。提示肝硬化合并感染是造成

病情加重，导致死亡的重要原因。这主要与机体免疫功能低下，高胆红素血症、白蛋白明显下降及肝功能

衰竭有关。而感染又常诱发生上消化道出血，肝性脑病及肝肾综合征等严重并发症，使肝硬化进展为慢性

重型肝炎、肝功能衰竭甚至多脏器功能衰竭而死亡，病死率明显增高。因此，肝硬化患者住院后应抓紧时

间检诊，在诊治过程中加强消毒隔离，严格无菌操作及掌握各种侵袭性操作的适应症，尽量减少医源性感

染的诱因。对肝功能child—pughC级患者采取绝对卧床休息、给予高热量、适量蛋白质(以植物蛋白为主)

、丰富维生素等易消化饮食，并应细嚼慢咽，绝对戒烟酒，加强口腔及皮肤护理，病情稳定后尽早出院。

发现感染征兆如不明原因的持续低热，黄疸明显升高，顽固性腹胀、腹痛、腹泻、腹水量明显增多或利尿

剂无效等，应及早作细菌培养，合理应用抗菌药物，加强支持利退黄治疗，积极预防和控制感染及严重并

发症的发生

The result �
2.1 Infect with 181 cirrhosises of the occurrence rate sufferer the merger infects with 101, infecting with 55.8% of the occurrence rate, the infection rate inside the hospital is 27.1%.�
2.2 Infection occurrence the part 101 infections totally take place a time of various infection is 133.4 among those exampleses infect with for 3 parts,24 the examples infect with for 2 parts

, Rest 73 the examples infect with for a part.Infect with the part press occurrence the 频 degree is high and low one by one in order is:At first the peritonitis 59 times of hair, the bowel way infects with 15, top

Breathe the way infects with 12 times, the disease 9 times of the germ blood, an infection of lung and pleuritis 8 for each time.An infection of 胆 , urine the road infects with to infect with 5 for each time with mouth cavity

, The soft organization of skin infects with 4 times, the shock 3 times of infection.�
2.3 Occurrence related factor � of the infection
2.3.1 A 101 of the relation infection of the infection and the liver function child- pugh ratings.A, B and the C class sufferer's numbers distinguish to 11,41 example and 49

Example.Infect with 80 of set not, A, B and the C class sufferer's numbers distinguish to 26,39 examples and 15s.The cirrhosis merger infects with the C class of child- pugh in set

The number of the sufferer is obvious and precious sight more to infect with the set not, two relatively differ to show the 著 ( x2=22.03, P<0.01) to see the table very much 1.�
Two livers function child- pugh ratings compare( X2)
Set do not the A B C is total
Infect with the set 11(20.6)41(44.6)49(35.7)101
Infect with the set not 26(16.4)39(35.4)15(28.3)81
Total 378064181
Note:The data inside the brackets counts for the theories of each number( T)
2.3.2 Hospital inside infection and hospitalization time relation hospitalization time> January,1/2-1 months and<1/ February hospital inside infection the occurrence rate is 63.2% respectively,

26.6%,10.2%.When the sufferer of the cirrhosis stay in the hospital> January the opportunity of the infection inside the occurrence hospital is obvious high in< the of January sees the table 2.
Hospital inside infect with and stay in the hospital the horary relation
Stay in the hospital the time infection number infection rate
<1/2510.2%s
1326.6%s of 1/2-1 months
>3163.2%s of January
2.3.3 Infection inside the hospital with encroach upon sex operation to relate to in 133 infections, accept to encroach upon sex to operate sufferer's number before list on 3 respectively is:25 example

The infection accepted the deep vein to place to take care of the 术 before,14 belly cavities wore to stab the 术 ,4 chests wore to stab the 术 .�
Problem complement:2.4 The cause learns the germs that the germs development have already examine to have:Rare germ( the stomach water) of the large intestine 埃 ;False single afterbirth germ( the stomach water);Smelly nose gram thunder 伯 surname germ(

Blood, phlegm, the bedsore 脓 liquid), 普 in the hair 斯 sand fungi( the blood, the neck vein puts the tube), the epidermis grape germ( phlegm), white beads germ( phlegm, muck,

Swallow to wipe the son), pull the surname west germ( phlegm), the ear grape germ( urine).�
2.5 The one who turn return to take place the infection dies of illness 29, the death rate is 28.7%;Don't the one who take place infection die of illness 2, death rate 2.5%.Rest 72 infections

Learn to examine the foundation in the cause up the reasonable usage antibiotics and protect the liver, the benefit urine etc. treatment, keep patient's mouth cavity and the whole body skin to sweep for the convenience of control infection etc.

Nursing descend all turn for the better the hospital discharge, the average hospitalization number is 25.9 days.Did not take place the infection of other 78 example at reasonable treatment and nursing under all turn for the better the hospital discharge, even

All stay in the hospital the day to count to 16.5 days.Cirrhosis merger infection death rate obvious high in not the one who infect with.( X2=21.6 Ps<0.01) see 3 �s of table
Infect with with not infect with death rate compare
The set do not die the number amendment number to add up
Infect with the set 29(17.3)72(83.7)101
Infect with the set not 2(13.7)78(66.3)80
Total 31150181
Two differences show the 著 meaning

2 results 2.1 infections formation rates 181 examples liver cirrhosispatient merges infects 101 examples, the infection formation rate55.8%, in the courtyard the infection percentage is 27.1%. 2.2 infections has the spot 101 examples infections altogether to haveeach kind of infection example order is 133. 4 examples are 3 spotsinfect, 24 examples are 2 spots infect Other 73 examples are a spot infect. The infection spotaccording to has the frequency height is in turn: Primary peritonitis59 examples, the intestinal tract infects 15 examples, on The respiratory tract infects 12 examples, bacteriemia 9examples, the lungs infection and pleurisy each 8 examples. Thebiliary duct infects, the urine road infection and the oral cavityinfects each 5 examples The skin soft tissue infects 4 examples, infectiousness is inshock 3 examples. 2.3 has the infection correlation factor 2.3.1 infections and liver function child - pugh graduationrelational infection group 101 examples. A, B and the C level patientpopulation respectively is 11 examples, 41 examples and 49 Example. The non- infection group 80 examples, A, B and the Clevel patient population respectively is 26 examples, 39 examples and15 examples. In liver cirrhosis merge infection group child - pugh Clevel The patient counts obviously are many to the non- infectiongroup, two groups compare the difference to be extremely remarkable(x2=22.03, P < 0.01) see Table 1. Two groups of liver function child - pugh graduation comparison (X2) Group other A B C grand total Infection group 11 (20.6) 41 (44.6) 49 (35.7) 101 Non- infection group 26 (16.4) 39 (35.4) 15 (28.3) 81 Amounts to 378064181 Note: In the parenthesis the data is various numbers theorynumber (T) In 2.3.2 courtyards infects with is hospitalized the timerelations to be hospitalized the time > in January, 1/2 ~ in Januaryand < 1/2 month courtyard 内感 dyes the formation rate respectivelyis 63.2%, 26.6%th, 10.2%. The liver cirrhosis patient is hospitalizedwhen > January has the opportunity which in the courtyard infectsobviously to be higher than < January (P < 0.01) to see Table 2. In the courtyard infects with is hospitalized the time relations Is hospitalized the time infection example number infectionpercentage < 1/2 5 10.2% 1/2 ~ in January 13 26.6% > In January 31 63.2% In 2.3.3 courtyards the infection and in the attack operationrelational 133 examples infection, accepts the attack operationpatient person sequence to the first 3 distinctions is: 25 examples Before the infection accepts the deep vein to set at the tubetechnique, 14 examples abdominal cavities puncture method, 4 exampleschest cavities puncture method. Question supplement that, 2.4 etiology bacilliculture examined thebacterium includes: Large intestine Egypt hopes the fungus (ascites);假单胞菌 (ascites); Smelly nose 克雷 伯氏 fungus ( The blood, the phlegm, the bedsore pus fluid), Purey Mao theSi sand mold (blood, neck vein inserts a tube), epidermis grape fungus(phlegm), white rosary fungus (phlegm, excrement, Swallows 拭子), pulls west west the peduncle the fungus(phlegm), ear grape fungus (urine). 2.5 revolutions turn over to have the infection to die of illness 29examples, the mortality rate are 28.7%; Has not had the infection todie of illness 2 examples, the mortality rate 2.5%. Other 72 examplesinfection The reasonable use antibiotic and guarantees treatment and soon liver, diuresis in the etiology examination foundation, maintainsthe patient oral cavity and the whole body skin cleanly in order tohelp the control infection and so on Under nurses all good extension to leave the hospital, equallyis hospitalized the number of days is 25.9 days. Under has not had theinfection other 78 examples reasonably to treat and to nurse all goodextension to leave the hospital, even Is hospitalized the number of days is 16.5 days. The livercirrhosis merge infection mortality rate obviously is higher than thenon- infection. (X2=21.6 P < 0.01) see Table 3 The infection compares with the non- infection mortality rate The group other death example number change for the betterexample number equals Infection group 29 (17.3) 72 (83.7) 101 Non- infection group 2 (13.7) 78 (66.3) 80 Amounts to 31150181 Two groups of differences have 显著性 the significance