关键词: 肝硬化, 上消化道出血, 美罗培南, 感染, 再出血

Abstract: Objective To investigate the preventive application of meropenem in patients with liver cirrhosis complicated by upper gastrointestinal bleeding（UGB）. Methods 92 patients with liver cirrhosis complicated by UBG were admitted to the ICU of our hospital between November 2016 and October 2018,and were randomly divided into the control and the observation group,with 46 patients in each group. Patients in the control group didn’t received antimicrobial therapy until the infection was identified,and patients in the observation group were intravenously given prophylactic meropenem administration at presentation. Blood procalcitonin （PCT） level was assayed. Results At the end of ten day treatment,one patient in the observation and two in the control died;in survivals in the observation,the white blood cell count was（5.6±1.9）×109/L,and blood PCT level was （0.25±0.03） ng/mL,significantly lower than （9.8±1.2）×109/L and（0.42±0.06） ng/mL in the control,while the platelet count was （106.2±15.7）×109/L,significantly higher than （93.6±20.1）×109/L in the control （P<0.05）;the re-bleeding rate and incidence of infection in the observation were 8.9% and 11.1%,both much lower than 25.0% and 43.2%,respectively,in the control（P<0.05）;a total of 8 strains and 24 strains were separated in the observation group and in the control group,respectively,and the main infected bacteria was Escherichia Coli in the two groups,followed by Klebsiella pneumonia. Conclusion Prophylactic use of antibiotics is feasible in patients with liver cirrhosis complicated by UGB,which might significantly reduce the incidences of nosocomial infection and re-bleeding.

Key words: Liver cirrhosis, Upper gastrointestinal bleeding, Meropenem, Infection, Re-bleeding