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中华实验和临床感染病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 193 -203. doi: 10.3877/cma.j.issn.1674-1358.2026.04.001

专家共识

肝硬化继发感染诊治专家共识
国家传染病医学中心, 北京医师协会器官移植专科医师分会   
  • 收稿日期:2026-06-07 出版日期:2026-08-15
  • 基金资助:
    国家重点研发计划(2023YFC2308805)

Expert consensus on diagnosis and treatment of secondary infections in liver cirrhosis

National Center for Infectious Diseases, Organ Transplant Specialist Physician Branch of the Beijing Medical Doctor Association   

  • Received:2026-06-07 Published:2026-08-15
引用本文:

国家传染病医学中心, 北京医师协会器官移植专科医师分会. 肝硬化继发感染诊治专家共识[J/OL]. 中华实验和临床感染病杂志(电子版), 2026, 20(04): 193-203.

National Center for Infectious Diseases, Organ Transplant Specialist Physician Branch of the Beijing Medical Doctor Association. Expert consensus on diagnosis and treatment of secondary infections in liver cirrhosis[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2026, 20(04): 193-203.

肝硬化患者因肝功能受损、免疫功能紊乱及肠道屏障功能异常,易发生各种感染并发症。继发感染不仅可诱发肝功能失代偿,还可导致急性-慢性肝衰竭、肝肾综合征及脓毒症等,严重影响患者预后。近年来,随着耐药菌感染增多及诊疗技术的发展,肝硬化继发感染的诊断与治疗面临新的挑战。本共识基于国内外最新指南、专家共识及循证医学证据,结合我国肝硬化患者的临床特点,对肝硬化继发感染的诊断、抗感染治疗、辅助治疗、特殊情况处理、预防措施以及监测随访等提出推荐意见,旨在为临床医师规范诊疗提供参考,进一步提高肝硬化患者感染防治水平,改善患者临床结局和长期预后。

Patients with liver cirrhosis are highly susceptible to various infectious complications due to impaired liver function, immune dysregulation and disruption of the intestinal barrier. Secondary infections not only precipitate the acute decompensation of liver function, but may also lead to severe outcomes such as acute-on-chronic liver failure, hepatorenal syndrome and sepsis, representing a major determinant of poor prognosis. In recent years, the increasing prevalence of antimicrobial-resistant pathogens and advances in diagnostic and therapeutic strategies have posed new challenges in the management of infections in patients with liver cirrhosis. Based on the latest guidelines from China and abroad, expert consensus statements, evidence-based medicine, and the clinical characteristics of patients with liver cirrhosis in China, this consensus provides recommendations on the diagnosis, antimicrobial therapy, adjunctive treatment, management of special clinical situations, preventive measures, monitoring and follow-up of secondary infections in liver cirrhosis. It aims to provide a reference for standardized clinical management, thereby further improve the infection prevention, control and enhance the patients’ clinical outcomes and long-term prognosis.

表1 共识推荐意见推荐等级与证据质量(GRADE分级)
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