肝病并发自发性细菌性腹膜炎诊治体会

目的探讨肝病并发自发性细菌性腹膜炎的发病因素、诊治及预后。方法收集安徽中医学院第一附属医院68例肝病患者并发自发性细菌性腹膜炎临床及实验室资料作回顾性分析,其中38例为肝硬化患者,12例为原发性肝癌患者,18例为重型肝炎患者。结果 68例患者中临床表现以发热为主（89.7%）,多数患者腹水多形核白细胞明显升高（86.8%）,腹水培养阳性率低（19.1%）,头孢类抗生素疗效佳,其中死亡16例（23.5%）。结论 SBP是肝病晚期的严重并发症,临床表现不典型,综合的分析与及时的诊断与治疗对于预后有着举足轻重的作用。

Liver disease complicated with spontaneous bacterial peritoneal

Objective To investigate the clinical features of spontaneous bacterial peritonitis（SBP）in patients with chronic liver disease.Methods The clinical manifestations and the laboratory examinations in 68 cases with chronic liver diseases were analyzed retrospectively,68 cases in which 38 patients with cirrhosis,12 patients with hepatocellular carcinoma and 18 patients with severe hepatitis.Results In all of patients fever are common（89.7%）,the absolute polymorphonuclear neutrophils（PMN）counts was elevated（86.8%）.The positivity of ascetic fluid culture was low（19.1%）,the third generation cephalosporin have high curative effect,and the mortality of patients with SBP was 23.5%（16 cases）.Conclusion SBP was severe complications in chronic liver disease,the clinical manifestations were atypia,correct and timing treatment can reduce the fatality rate of chronic liver disease with SBP.