肝硬化并发自发性细菌性腹膜炎102例分析

目的探讨肝硬化并发自发性细菌性腹膜炎（SBP）菌株种类、临床特点及治疗。方法对102例住院肝硬化并发SBP临床资料回顾性分析。结果102例患者近半数无明显腹膜刺激征。88例（86．27％）患者腹水多核细胞（PMN）比值≥0．50。26例腹水细菌培养呈阳性，共分离细菌28株，大肠埃希菌占46．43％。腹水蛋白≤10g／L，并发SBP发生率高于腹水蛋白〉10g／L患者。两者差异显著（P〈0．01）。结论肝硬化并发SBP临床症状多不典型，腹水PMN比值是诊断SBP较可靠的参数。病原菌以大肠杆菌为主。腹水蛋白≤10g／L患者应警惕SBP的发生，宜及早行腹水检查。SBP患者宜早期抗生素治疗，不必待腹水细菌培养回报。

Clinical analysis of spontaneous bacterial peritonitis in 102 liver cirrhosis cases

[Objective] To investigate the strain type , clinical features and therapy of spontaneous bacterial peritonitis (SBP) with liver cirrhosis. [Methods] The clinical data of 102 patients with liver cirrhosis complicated by SBP were analysed retrospectively. [Results] Among these cases, nearly half mumber of patients didn't have the obvious abdominal tapping and 88 patients(86.27%)percent of polymorphonuclear were higher than 0.50. 26 patients bacterial culture in ascites showed positive and 28 organisms were isolated, E. coli accounted for 46.43%. Compared with that in the patients whose concentration of ascites protein were more than 10 g/L, the incidence of SBP was higher in the patients whose concentration of ascites protein were less than 10 g/L, the differences was remarkable (P <0.01). [Conclusion] The clinical symption of liver cirrhosis complicated by SBP are mild, the ratio of PMN in ascites is a reliable parameter to diagnose SBP. E. coli is mainly in the pathogenic bacterium. The patients whose concentration of ascites protein are less than 10 g/L must be taken take care of the complication OF SBP and ascites inspection in early time is suitable. For SBP, it is necessary to treat with antibiotic in early time, not waiting for the result of the bacterial culture in ascites.