中文摘要：

目的探讨预防性应用抗菌药物降低老年患者肝硬化急性上消化道大出血医院感染的疗效,寻找预防医院感染的有效方法,以降低医院感染率。方法选取2012年4月-2014年4月73例老年肝硬化急性上消化道大出血患者为研究对象,随机分为治疗组37例和对照组36例,两组患者均予禁食、抗休克、扩充血容量、止血等常规治疗,治疗组患者在此基础上加用头孢哌酮/舒巴坦3.0g静脉滴注,至出血停止后7d;观察比较两组患者临床指标,数据采用SPSS 18.0进行统计分析。结果治疗组与对照组患者医院感染率分别为21.6%与47.2%,且治疗组发生各种感染率及混合感染率均明显低于对照组,差异有统计学意义（P〈0.05）;患者治疗有效率和病死率分别为78.4%和13.5%,对照组患者分别为55.6%和27.8%,治疗组均优于对照组,差异有统计学意义（P〈0.05）。结论抗菌药物预防性应用可明显降低老年肝硬化急性上消化道大出血患者医院感染率和病死率,提高其生活质量,疗效肯定。

英文摘要：

OBJECTIVE To evaluate the efficacy of prophylactic antibiotics in reducing infections in elderly liver cir‐rhosis patients with acute upper gastrointestinal bleeding so as to find effective ways to prevent hospital infections . METHODS From Apr .2012 to Apr .2014 ,totally 73 cases of elderly liver cirrhosis patients with acute upper gas‐trointestinal bleeding were chosen as study objects .They were randomly divided into treatment group with 37 ca‐ses and control group with 36 cases .Both groups were forbidden for food and treated with conventional treatments like antishock ,blood volume expansion and bleeding stopping .In addition to these ,the treatment group was trea‐ted with intravenous drip of cefoperazone/sulbactam for 7 days after the blood was stanched .The clinical indica‐tors of the two groups were observed and all data were statistically analyzed by SPSS 18 .0 software .RESULTS The hospital infection rates in the treatment group and control group were 21 .6 % and 47 .2 % respectively .In‐fection rates and mixed‐infection rates in the treatment group were significently lower than those of the control group （P〈0 .05） .The effective rate and mortality rate in the treatment group were 78 .4 % and 13 .5 % and in the control group ,they were 55 .6 % and 27 .8% .The treatment was superior to the control group in curative effect .The differences were significant （P〈0 .05） .CONCLUSION Prophylactic antimicrobial agents can signifi‐cantly reduce hospital infections rate and mortality rate in patients with massive hemorrhage of gastrointestinal tract and can improve their life quality with definite curative effect .