肝硬化腹水并自发性细菌性腹膜炎的预后因素分析

目的：评价影响肝硬化腹水并自发性细菌性腹膜炎（SBP）预后的主要因素。方法：回顾性分析19例肝硬化腹水并SBP患者的一般状况，肝硬化原因，SBP的特征病理生理，伴随状况等16项观察指标与病死率的关系。结果：19例肝硬化腹水并SBP死亡9例，病死率为47．4％，腹水多核粒细胞占粒细胞的比例，腹水Rivalta,BUN,Cr，顽固性腹水，Child-Pugh分级差，多器官功能衰竭7个因素在生存与死亡组之间的差异，有统计学意义（P＜0．05），与死亡有密切关系，结论：肝硬化腹水并发SBP病死率高，SBP的诊断及预后应重视腹水多核粒细胞比例和Rivalta实验。当肝硬化腹水并发SBP，同时又伴有肝，肾功能不良和顽固性腹水或多器官功能衰竭时提示患者预后不良。

Analysis of the prognostic factors of spontaneous bacterial peritonitis in patients with cirrhosis

Objective:This study attempts to correlate the mortality of spontaneous bacterial peritonitis in patients with liver cirrhosis to numerous etiologic and clinical variables. Methods: A retrospective review of 19 patients with spontaneous bacterial peritonitis associated with cirrhosis was performed. Sixteen factors consisting of demographics, causes of cirrhosis, the peritoneal fluid routine test,clinical variables of liver cirrhosis and prognosis,were studied. Results:Mortality rate was 47.4 percent.The significant predictors of mortality (P<0.05) in this study were the proportion of the PMN cell count to the neutrocyte population,Rivalta's test serum creatinine,obstinate ascites,Child's classification,multiorganic failure. Conclusion :The spontaneous bacterial peritonitis in patients with cirrhosis has considerable high mortality. The proportion of the FMN cell count to the neutrocyte population and Rivalta's test are emphasized in diagnosing and prognosis SEP. Whenever this kind patients present failure of liver or kidney function,or obstinate ascites,the patients outcome are unfortunate.