重型肝炎和肝硬化并发自发性细菌性腹膜炎145例临床分析  

Clinical analysis on 145 cases of sever virial hepatitis and cirrhosis complicated with spontaneous bacterial peritonitis

作　　者：陈瑞烈[1] 朱文平[1] 王文峰[1] 刘敏[1] 洪奋玲 

机构地区：[1]汕头市第二人民医院感染科,广东汕头515011

出　　处：《中国基层医药》2005年第1期5-6,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨重型病毒性肝炎和肝硬化并发自发性细菌性腹膜炎(SBP)病原菌种类以及临床特点。方法对145例重型病毒性肝炎和肝硬化并发SBP患者的临床资料进行回顾性分析。结果145例患者中123例(848%)腹水多形核白细胞(PMN)比值≥050。78例腹水细菌培养阳性(538%),共分离细菌82株,包括11种细菌,病原菌以革兰阴性杆菌为主,大肠杆菌40株,为主要致病菌,占488%。药敏试验对第三代头孢菌素和第三代氟喹诺酮类药物敏感。结论重型病毒性肝炎和肝硬化并发SBP临床表现大多数不典型,腹水PMN比值是诊断SBP的可靠指标。大肠杆菌为主要致病菌。抗感染治疗首选第三代头孢菌素和第三代氟喹诺酮类药物。Objective To estimate the pathogen types and their clinical character of sever virial hepatitis(SH) and cirrhosis complicated with spontaneous bacterial peritonitis(SBP).Methods The clinical data of 145 cases SH and cirrhosis with SBP were retrospective analysed.Results The ratio of polymorphonuclear leukocyte(PMN) in ascites was 84.8%(123/145).78 cases' bacterial cultivation were postive(53.8%),and seperated 82 strains,including 11 types of bacteria,gram-negative bacillus were prevaining,the most important pathogen was colibacillus,which had 40 strains(48.8%).They were sensitive to the third generation cephalosporin and third generation FQNS.Conclusions The clinical situation of SH and cirrhosis complicated with SBP were atypical mostly,the ratio of PMN in ascites was a reliable index in diagnosing SBP.Colibacillus was the most important pathogen and third generation cephalosporin and third generation FQNS should be selected in anti-infection treatment.

关 键 词：肝硬化 自发性细菌性腹膜炎 SBP 腹水 重型病毒性肝炎 第三代头孢菌素 PMN 结论 敏感 目的 

分 类 号：R575.1[医药卫生—消化系统] R575.2[医药卫生—内科学]