晚期肝炎后肝硬变并自发细菌性胸膜炎

目的 研究晚期肝炎后肝硬变(LC)患者并发自发性细菌性胸膜炎(SBPL)的临床特征、诊断和治疗。 方法 分析6例LC患者8次并发SBPL的临床表现和治疗结果。 结果 LC并SBPL的主要临床特征为:①有肝性胸水(83.3％为中量以上)。②突然或迅速加重的胸或胸腹痛、胸闷气短、胸水量迅速增加伴少尿或无尿、发热、黄疸或黄疸加深。③胸水为渗出液,胸膜呈化脓性炎症改变、胸水细菌培养可阳性(4例次,均为肠杆菌科)。 结论 当LC患者出现SBPL表现时,应及早诊断。及早应用抗G~-菌等抗生素治疗,预后良好。

Spontaneous bacterial pleuritis: A severe complication in patients with late post-hepatitis cirrhosis

AIMS To study the clinical traits, diagnosis and treatment of spontaneous bacterial pleuritis (SBPL) in patients with late posthepatitis cirrhosis (LC).METHODS The Clinical manifestations, diagnosis and treatment were analysed in six LC patients with SBPL (eight episodes). RESULTS Main clinical traits of SBPL were that patients whose hy-drothorax were more than moderate volume showed thoracic and abdominal pain, dyspnea, fever, jaundice or aggravating jaundice, quickly increased pleural effusion(PE) accompanied with oliguria even anuria, and the PE was exudates, a septic lesion was found in the thoracic membrane and bacterial cultures of the PE were positive in four of eight patients, which were all intestinal bacteria in origin. CONCLUSIONS SBPL is a rare and severe complication in late hepatic cirrhosis. It is necesary to diagnose in time and potent anti-gramnega-tive antibiotics should be given as soon as possible so that patients with SBPL may have a good prognosis.