肝硬化失代偿并发不典型腹水感染的治疗分析

目的探讨肝硬化失代偿并发不典型腹水自发性感染的诊治方法并分析影响患者预后的相关因素，为临床实践提供参考依据。方法选择2009年6月-2012年6月浙江省诸暨市人民医院感染内科收治的86例肝硬化失代偿并发不典型腹水自发性感染患者作为研究对象，采用抗菌类药物二联或三联制剂进行治疗，分析疗效及预后影响因素。结果79例患者治疗有效，有效率为91．86％，7例患者因肝肾综合征、上消化道大出血、肝性脑病及继发感染性休克而死亡。肝硬化分级及消化道出血、肝肾综合征、肝性脑病等并发症对患者预后的影响显著（P〈0．05）。结论肝硬化分级及并发症对肝硬化失代偿期并发不典型腹水感染患者的预后有显著影响，尽早合理科学地使用抗生素，同时根据患者自身情况配合使用其他药物进行治疗，可有效提高患者的健康水平，显著降低病死率。

Treatment analysis of decompensated cirrhosis complicated with atypical ascites infection

Objective To investigate the diagnosis and treatment methods of decompensated cirrhosis complicated with atypical ascites spontaneous infection, and analyze the factors affecting in order to provide the reference for clinical practice. Methods 86 patients with decompensated cirrhosis complicated with atypical ascites from June 2009 to June 2012 in Infec- tion Medical Department of People＇s Hospital of Zhuji City were selected as the research object. All the patients were treated by the duplex or trigeminy use of antibacterial agents, and the curative effect and prognostic factors were analyzed. Results 79 cases were effective treatment, effective rate was 91.86%. 7 cases were dead because of hepatorenal encephalopathy, upper gastrointestinal bleeding, hepatic encephalopathy and secondary to septic shock. The influence of cirrhosis of the liver classification and gastrointestinal bleeding, hepatorenal syndrome and hepatic encephalopathy on the prognosis was significant （P 〈 0.05）. Conclusion The grading and complications of cirrhosis have significantly influence on the prognosis of decompensated cirrhosis complicated with atypical ascites infection, the reasonable earlier and scientific applications of antibiotics and use the other drugs according to the patients＇ condition at the same time can effectively improve the health level and significantly reduce the mortality rate.