肝硬化食管胃静脉曲张经内镜下组织胶治疗术后感染危险因素

Risk factors for positive infections in patients with liver cirrhosis and esophagogastric varices undergoing endoscopic cyanoacrylate injection

  • 摘要: 目的 探究肝硬化食管胃静脉曲张破裂出血患者内镜下组织胶治疗术后感染的危险因素,为临床防控策略的制定提供依据。方法 选取2023-2024年于解放军总医院第一医学中心接受内镜下组织胶治疗的肝硬化食管胃静脉曲张患者共173例为研究对象,根据术后是否发生感染分为感染组24例和非感染组149例。收集两组患者临床资料,包括:一般人口学特征、生命体征、合并疾病、营养状况、实验室指标、治疗操作情况,应用logistic回归分析术后感染危险因素。结果 术后感染患者24例,其中血流感染2例,腹腔感染22例。单因素分析结果显示,感染组与非感染组患者年龄≥55岁、合并糖尿病及具有营养风险(营养评分≥3分)比较,差异具有统计学意义(P<0.05),多因素分析结果显示,年龄≥55岁(OR=2.897,P=0.034)、合并糖尿病(OR=3.592,P=0.008)是内镜下组织胶注射治疗术后感染的危险因素。结论 年龄、合并基础疾病是肝硬化食管胃静脉曲张破裂出血经内镜下组织胶注射治疗术后感染的危险因素。

     

    Abstract: OBJECTIVE To explore the risk factors for postoperative infections in the patients with liver cirrhosis and esophagogastric varices bleeding who were treated with endoscopic cyanoacrylate injection (ECI) so as to provide bases for development of clinical prevention and control strategies. METHODS Totally 173 patients with liver cirrhosis and esophagogastric varices who were treated with ECI in the First Medical Center of Chinese PLA General Hospital from 2023 to 2024 were recruited as the research subjects and were divided in the infection group with 24 cases and the non-infection group with 149 cases according to the status of postoperative infections. The clinical data, including general demographic characteristics, vital signs, complications, nutrition status, laboratory test indicators, and treatment procedures, were collected from the two groups of patients. Logistic regression analysis was performed for the risk factors for the postoperative infections. RESULTS A total of 24 patients had postoperative infections, of whom 2 had bloodstream infections, and 22 had abdominal infections. The result of univariate analysis showed that there were significant differences in the no less than 55 years of age, complication of diabetes mellitus and nutritional risk (nutrition score no less than 3 points) between the infection group and the non-infection group (P<0.05). The result of the multivariate analysis indicated that the no less than 55 years of age (OR=2.897,P=0.034) and complication of diabetes mellitus(OR=3.592,P=0.008) were the risk factors for the postoperative infections in the patients who were treated with ECI. CONCLUSION The age and complication of underlying diseases are the risk factors for the postoperative infections in the patients with liver cirrhosis and esophagogastric varices bleeding who are treated with ECI.

     

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