自发性细菌性腹膜炎易感因素分析

目的分析自发性细菌性腹膜炎 (SBP)的易感因素 ,选择预防性抗菌治疗对象。方法将 30 7例肝硬变腹水患者按有无胃镜检查、嗜酒、Child Pugh分级、消化道出血、SBP病史等因素 5次分组 ,比较各组SBP发生率。 结果嗜酒者SBP发生率 2 5 .0 % ,非嗜酒者为 1 4 .6 % ;Child PughC级SBP发生率为 2 4 .0 % ,Child PughB级为 1 2 .4% ;消化道出血者SBP发生率为 2 7.5 % ,无消化道出血者为7.9% ;有SBP病史者发生率 66 .7% ,无SBP病史者为 1 0 .9%。其发生率均具有显著性差异。而有或无胃镜检查 ,其SBP发生率无显著差异。结论嗜酒、消化道出血、SBP病史以及Child Pugh分级作为SBP易感因素可以预测SBP的发生 ,采用选择性肠道去污染等办法可以降低SBP的发生率 ,改善预后。

Analysis of the predisposing factors of the spontaneous bacterial peritonitis

Objective To analyze the predisposing factors of the spontaneous bacterial peritonitis(SBP) and to select the preventive antibacteria treating patients. Methods 307 hepatocirrhosis patients were divided into 2 groups according to the five following factors:endoscopy examination, addiction to drinking, Child-Pugh grade, gastrointestinal hemorrhage and history of SBP. Comparison of SBP occurrence rate was made between the different groups. Results SBP occurrence rate in the patients addicted to drinking was 25.0%, which was 14.6% in the non-drinking patients. SBP occurrence rates in Child-Pugh C grade patients and B grade patients were 24.0% and 12.4%, respectively, which were 27.5% and 7.9%, respectively, in the patients with gastrointestinal hemorrhage and without gastrointestinal hemorrhage, while the occurrence rates of SBP were 66.7% and 10.9% in the patients with SBP history and without SBP history. There was significant difference between the occurrence rates, but there was no significant difference between the occurrence rate of SBP in the patients undergoing or not undergoing endoscopy examination. Conclusion The predisposing factors including addiction to drinking, gastrointestinal hemorrhage, SBP history and Child-Pugh grade can foresee the occurrence of SBP, which can be reduced by selective intestinal decontamination.Additionally, prognosis is improved.