Liver Cirrhosis Intercurrent Lung Infection Clinical Research

OBJECTIVE:Studies with liver cirrhosis complicated factors affecting lung infection, pathogens and clinical characteristics and voriconazole and imipenem combined drugs in treatment effect, explore the impact of liver cirrhosis complicated by lung infection factors can be used as concurrent lung independent factors affecting infection, study cirrhosis complicated by pulmonary infection and the body of bacteria and fungi. Relevance, and finally explore the effect the voriconazole and meropenem combined drugs in the treatment of liver cirrhosis complicated with pulmonary infection for early clinical the diagnosis and treatment of liver cirrhosis complicated by lung infection provide a new experimental basis.METHODS:1) Select the518cases of liver cirrhosis patients for the study, through the past, the patient’s gender, age, hospitalization time, cirrhosis child-Pugh classification, merging underlying diseases (diabetes, chronic heart and lung disease), multiple factors such as complications, follow-up were retrospectively analyzed;2) Select the liver hard of patients with462human subjects were observed in patients with cough or expectoration symptoms, bilateral or single side of the lung auscultation or percussion dullness, X-ray shows the lungs there are exudative lesions, fever, body temperature, ultraover38℃, WBC10X109/L, in a different time to cultivate the same kind of deep sputum pathogens. On the positive and other clinical symptoms in patients with pathogens in vivo and clinical analysis of the characteristics;3) Election Choose a study of53cases of cirrhosis patients with lung infection for injection for patients voriconazole and meropenem combined drugs and meropenem only treatment of comparative analysis of the degree of remission of symptoms and pneumonia lesions absorption dissipated as an indicator of treatment effect analysis of these two drugs.RESULTS:1) This study518cases of cirrhosis in patients with concurrent pulmonary infection in patients with144cases, the incidence rate of27.79%.①the child-Pugh grade C level, these patients liver function is severely damaged, the body immune protein, albumin, and humoral factors to reduce portal hypertension and collateral circulation in the immunity significantly decreased.②in elderly patients (≥60years) compared to younger patients with more sense of pulmonary transfection. The③viral hepatitis caused by cirrhosis of the liver than other causes of cirrhosis is more likely to lead to pulmonary infections.④vomiting, aspiration, extensive use of the PPI factors on liver cirrhosis complicated with gastrointestinal bleeding patients with gastrointestinal bacterial migration, often lead to or aggravate lung infection.⑤suffering from diabetes disease, cardiovascular disease and chronic obstructive pulmonary disease in patients with cirrhosis will lead to lung infections. The longer the duration of hospitalization, exogenous bacterial infection probability increases, the probability of infection of the lungs of patients is gradually increasing.2)7cases of patients with no clinical symptoms accounted for10.4%, but chest X-ray detected in the lungs of infection.67patients,48cases of patients with a body of deep sputum pathogen cultured of which36cases were positive, the positive rate of75.0%. Were isolated pathogens78, including11kinds of bacteria64Strains, mainly in Gram-negative bacteria, Pseudomonas aeruginosa24, accounting for30.8%, as the main pathogenic bacteria; six kinds of fungi,14. Eight cases of patients with mixed infection of two or more pathogens.3) Voriconazole and meropenem combined drugs of patients with cure rates of33.3%, in patients with markedly effective rate was63.0%, total effective rate; meropenem the cure rate of patients with19.2%from96.3%in patients with markedly effective rate was57.7%, with a total effective rate of76.9%. Voriconazole and meropenem significantly superior to the meropenem treatment difference was statistically significance (P<0.05), treatment of patients with liver function does not exist anomalies.CONCLUSION:1) Older than people with other underlying diseases, a serious condition, more complications, hospital stay, and many other factors the patient’s condition affects both older (≥60years), underlying diseases and long hospital stay factor is not the independence of the influencing factors.2) The patient’s body more pathogens, but easy to treat mixed bacteria infection status.3) Voriconazole and meropenem in treatment is better than meropenem only.