肝硬化合并自发性细菌性腹膜炎患者的临床细菌检测分析  

CLINICAL ANALYSIS OF PATHOGENS IN LIVER CIRRHOSIS PATIENTS WITH SPONTANEOUS BACTERIAL PERITONITIS

作　　者：廖致红[1] 蒋洪昆[1] 侯蓓蕾[1] 马丽梅[1] 潘柳吟[1] 徐秋红[1] 

机构地区：[1]广西壮族自治区柳州市人民医院检验科,柳州545006

出　　处：《现代预防医学》2009年第19期3748-3749,共2页Modern Preventive Medicine

摘　　要：[目的]探讨肝硬化合并自发性细菌性腹膜炎(SBP)的临床诊断标准及病原菌分布特点。[方法]以肝硬化合并SBP腹水细菌培养阳性的患者共65例为观察对象,进行细菌培养、鉴定和耐药性试验。[结果]细菌培养共分离出细菌30株,其中革兰阴性菌16株(53.3%),革兰阳性菌11株(36.7%),其他菌3株;革兰阴性菌对三代头孢菌素的耐药率达40%以上,革兰阳性菌三代头孢菌素与青霉素都有较高的耐药率。[结论]诊断SBP除应尽早进行腹水培养外,还要结合临床症状,依据耐药报告结果合理选用抗菌药物。[Objective] To investigate the clinical diagnostic criteria and distribution of pathogens in fiver cirrhosis patients with spontaneous bacterial peritonitis. [Methods] Ascitie fluid culture was positive in 65 eases of liver cirrhosis eombined with SBP, and then performed bacterial culture, bacterial identification and drug-resistance test. [ Results] 30 bacterial strains were isolated, among them, gram-negative bacteria constituted 53.3% （ 16 strains）, gram-positive bacteria constituted 36.7% （11 strains）, and other bacteria 3 strains; drug resistance test showed that the resistance rate of gram-negative bacteria to the third generation cephalosparin, was over 40%, and gram-positive bacteria had high resistance to the third generation cephalosparin and penicillin. [ Conclusion] The diagnosis of SBP with cirrhosis mainly depends on both of ascitie results and clinical symptoms. The clinician should reasonably choose the antibiotics according to the test results of the pathogen sensitivity to drugs.

关 键 词：肝硬化 自发性细菌性腹膜炎 耐药性 抗菌药物 

分 类 号：R657.31[医药卫生—外科学]