Management and prognosis of HIV infected patients with postoperative sepsis

摘要

To investigate the management and prognosis of HIV infected patients with postoperative sepsis, the clinical data of 126 HIV-infected patients aged 20to74 years including 114 males and 12 females were retrospectively analyzed. Patients were divided into 3 groups according to the pre-operative level of CD4+ cells: Group A (n=73),&200 cells/μl; Group B (n=36): 200 cells/μl≤CD4+ cells&350 cells/μl; Group C (n=17): ≥350 cells/μl. The operation was carefully performed aiming to reduce the damage to tissues. Antibiotic prophylaxis, treatments with anti-tuberculous, antifugal and anti-retroviral drugs and timely treatment of complications were carried out. In Group A, B and C, postoperative sepsis occurred in 32, 8 and 3 patients, respectively, of whom 4, 1 and 0 died of multiple organ dysfunction syndrome (MODS), respectively. Analysis showed the proportion of patients with sepsis in Group A was significantly higher than that in Group B and Group C, but no significant difference was found between Group B and C. The HIV infected patients with CD4+ cells &200 cells/μl had significantly increased risk for postoperative sepsis. Appropriate peri-operative treatment for HIV-infected patients may achieve favorable outcome.