107例肝硬化合并自发性细菌性腹膜炎的临床研究

目的为及时救治肝硬化合并的自发性细菌性腹膜炎(SBP),以提出早期诊断及影响预后的因素。方法对107例病人进行临床研究,观察年龄、性别、肝硬化病因、SBP发生率及院内感染率、细菌学检查及药敏试验,并设置对照组比较肝功能、血常规、腹水常规、B超、Child-pugh分级和并发症。结果肝硬化病因以HBV感染为主(83.2);男性居多,同期住院病人中合并SBP者为21.6%,其中医院内感染率16.8%腹水培养致病菌阳性率14%,以单菌株G-杆菌为多数(66.7%)。药敏试验提示耐药率超过50%的依次为青霉素、氨曲南、氧氟沙星。与对照组比较ChildC级例数明显增多(P<0.05);腹水WBC计数明显升高(P<0.05),Rivanlta试验(+)率显著增加(P<0.001)血清ALB值有降低的趋势(P=0.089)。末梢血WBC计数及腹水Rivanlta试验(+)与Child分级、血清BUN呈正相关,与ALB呈负相关。结论SBP多为单菌株、G-杆菌感染,青霉素及奎诺酮类耐药。早期诊断性腹腔穿刺非常必要。ChildC级、低ALB血症是SBP的罹患因素。

Clinical Reasearch of 107 liver cirrhosis with SBP

Objective To treat the spontaneous bacterial peritonitis (SBP) of liver cirrhosis and to indicate the factors of early diagnosis and progrosis . Methods There were 107 patients, we observed age,sex,causes of liver cirrhosis,incidental rate of SBP and infection rate in thethe hospital,bacteria examination and drug allergy test. By setting control group, we compared liver function,blood routine,ascites routine,B supersonic examination,Child-pough Grading and complications. Results Cirrhosis mainly resulted from HBV infection(83.2%);Most of patients were male;Cirrhosis patients associated with SBP accounted for 21.6%,in which infection rate in the hospital accounted for 16.8%;becteria positive rate of ascites cultivation was 14%,most bacteria were monobacteria,G -bacillus(66.7%);Drug allergy test indicated drug resistance rate exceeds 50%,in the followorder penicillin,amino-group,oxygen-fluonine killer.Comparing with control group,cases of Child-pough grade C were abviously more( p <0.05);Ascites WBC counting was high( P <0.05);the positive rate of Rivanla test increased obviously( P <0.001);serum level of Alb had the tendency to become lower( p =0.089).WBC counting of tip blood and Ascites Rivalta(+) were in positive relation of Child-pough grade,serum level of BUN and in negative relation of serum level of Alb. Conclusions SBP is infected by monobacteria and G- bacilli most,and has drug resistance of penicillin and quinoline .It is necessary to make belly puncture for early diagnosis.Child-pough grade C ,lower serun level of Alb abr the leading factors of SBP.