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肝硬化合并感染的早期识别与经验性治疗
Early diagnosis and empiric therapy for cirrhosis associated with infection
文章发布日期:2015年02月12日  来源:  作者:南月敏 ,牛学敏  点击次数:1988次  下载次数:497次

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【摘要】:感染是肝硬化的常见并发症,常见感染部位包括肺部、胸腹腔、胆道、尿道、软组织及皮肤等,部分患者可出现自发性菌血症。简述了肝硬化合并感染的危险因素及常见感染类型,针对各种感染要早期识别及对症支持治疗,指出肝硬化合并感染是导致疾病进展的重要因素,其早期识别与治疗是治疗成功的关键。三代头孢菌素为一线抗菌药物。耐药菌应选择含有β-内酰胺酶抑制剂的复方抗菌素或碳青霉烯类药物,甲氧西林耐药的金黄色葡萄球菌感染选用糖肽类抗菌素或联合用药。肺真菌病以卡泊芬净和伏立康唑为主要治疗药物,联合白蛋白等支持治疗可提高疗效,改善预后。
【Abstract】:Infection is a frequent complication of cirrhosis, which often occurs in the lungs, chest, abdomen, biliary tract, urinary tract, soft tissue, and skin, and occasionally causes spontaneous bacteremia in patients. This paper reviews the risk factors and common types of infection in cirrhosis associated with infection, and the early diagnosis and symptomatic treatment of different types of infection. Moreover, this paper points out that cirrhosis associated with infection is a key factor for disease progression and the early diagnosis and treatment are essential for successful treatment. The third-generation cephalosporins are the first-line antibiotic agents. Drug-resistant bacteria should be treated with antibiotic compound containing β-lactamase inhibitors or carbapenems. Methicillin-resistant Staphylococcus aureus should be treated with glycopeptide antibiotics or combination therapies. Pulmonary mycoses are mainly treated with caspofungin or voriconazole. Antibiotics combined with supportive therapies including the administration of albumin can improve the treatment outcome and prognosis.
【关键字】:肝硬化;感染;早期诊断;治疗
【Key words】:liver cirrhosis; infection; early diagnosis; therapy
【引证本文】:

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