腹腔灌洗加腹腔注射抗生素治疗难治性自发性腹膜炎的临床评价  

Clinical evaluation of peritoneal lavage combined with intraperitoneal injection of antibiotics in the treatment of intractable spontaneous bacterial peritonitis

作　　者：赵夏平[1,2] 翟卫春[2] 冯娟[2] 于晓辉[2] 

机构地区：[1]兰州大学研究生院第二临床医学院,甘肃兰州730000 [2]兰州军区兰州总医院消化科

出　　处：《胃肠病学和肝病学杂志》2013年第8期797-799,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：兰州军区全军医药卫生科研项目(CLJILJA02)

摘　　要：目的为探讨分析腹腔灌洗及腹腔内注入抗生素对肝硬化并发难治性自发性腹膜炎(SBP)及顽固性腹水的治疗价值。方法 28例肝硬化合并SBP腹水的患者,均给予经静滴抗生素、利尿、输注白蛋白等对症支持治疗,之后行腹腔灌洗术,再向腹腔注入抗生素。结果给予支持治疗后,20例患者SBP症状无明显改善,腹水PMN>2.5×108/L,1例患者症状明显加重,7例患者腹水PMN<2.5×108/L;经腹腔灌洗加腹腔内注射抗生素治疗后,26例(92.86%)患者SBP症状消失,腹水消退。结论腹腔灌洗加腹腔内注入抗生素是治疗肝硬化合并难治性SBP和顽固性腹水的有效方法之一。Objective To analyze the value of peritoneal lavage combined with intraperitoneal injection of antibiotics in the treatment of liver cirrhosis with refractory spontaneous bacterial peritonitis （SBP） and refractory ascites. Methods 28 cases of cirrhosis with SBP and ascites were intravenous infused with antibiotics, diuretic, albumin and so on. Then, peritoneal lavage was done and antibiotics were injected into abdominal cavity. Results After supportive treat- ment, the SBP symptom in 20 patients had no significant amelioration, ascites PMN was more than 2.5× 10^8/L. 1 pa- tient aggravated, ascites PMN was less than 2.5 × 10^8/L in 7 patients. After peritoneal lavage and intraperitoneal injec- tion of antibiotics, peritonitis symptoms disappeared, and ascites resolved in 26 （92.85%） cases. Conclusion Perito- neal lavage combined with intraperitoneal injection of antibiotics is an effective method in the treatment of liver cirrhosis with refractory spontaneous bacterial peritonitis （SBP） and refractory ascites.

关 键 词：肝硬化 自发性腹膜炎 腹水 腹腔灌洗 抗生素 

分 类 号：R575[医药卫生—消化系统]