摘要
目的探讨肝硬化合并自发性腹膜炎(SBP)的临床特点。方法回顾分析106例患者的临床资料。结果SBP患者病死率、发生率与细菌种类、腹腔积液中性白细胞(PMN)数、腹腔积液白蛋白值等有一定关系。外周血WBC>10×10^9/L者20例,中性粒细胞比例>75%者7例,腹水WBC≥0.5×10^9/L者32例,PMN≥0.25×10^9/L者48例。腹水细菌培养阳性38例,检出革兰氏阴性菌24例,其中大肠埃希球菌14例、肺炎克雷伯菌6例,革兰氏阳性菌14例,其中金黄色葡萄球菌7例、表皮葡萄球菌5例。结论肝硬化腹水患者不明原因发热、腹痛、短期内腹水迅速增多或外周血白细胞、中性粒细胞比值升高应警惕SBP的发生,早期诊断、及时运用抗生素治疗是改变SBP预后的关键,腹腔积液PMN>0.25×10^9/L、白蛋白低于10g/L提示预后不良,病死率高。
Objective To investigate the liver cirrhosis and spontaneous bacterial peritonitis（SBP） of clinical features.Methods A retrospective analysis of 106 patients with clinical data.Results of mortality of patients with SBP,the incidence and types of bacteria,peritoneal fluid neutrophils（PMN） number,such as ascites albumin has a certain relationship.Peripheral WBC 10 × 10 ^ 9 /L in 20 cases,the proportion of neutrophils 75% in 7 patients,ascites WBC ≥ 0.5 × 10 ^ 9 /L in 32 cases,PMN ≥ 0.25 × 10 ^ 9 /L48 cases.Ascites bacterial culture was positive in 38 cases,Gram-negative bacteria detected in 24 cases,of which E.coli bacteria in 14 cases,Klebsiella pneumonia,6 cases of Gram-positive bacteria in 14 cases,including Staphylococcus aureus in 7 cases,the epidermisStaphylococcus aureus in 5 cases.Conclusion Patients with liver cirrhosis of unknown cause fever,abdominal pain,rapid increase in short-term ascites or peripheral blood leukocytes,neutrophils,increased the ratio of SBP should be alert to the occurrence of early diagnosis and timely use of antibiotics is the key to change the prognosis of SBP,hemoperitoneumfluid PMN 0.25 × 10 ^ 9 /L,albumin less than 10g /L indicates a poor prognosis and high mortality.
出处
《求医问药（下半月刊）》
2011年第10期314-314,共1页
Seek Medical and Ask The Medicine
