资源描述：
《乙型肝炎肝硬化腹水并自发性细菌性腹膜炎52例临床分析.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、2336重庆医学2009年9月第38卷第18期临床研究乙型肝炎肝硬化腹水并自发性细菌性腹膜炎52例临床分析曾令勇,何志兵,袁晓玲(四川省内江市第三人民医院消化内科641000)摘要:目的了解乙型肝炎肝硬化并发自发性细菌性腹膜炎(SBP)的临床特征。方法回顾性分析52例乙型肝炎肝硬化腹水并发SBP患者的临床特征,实验室检查结果,腹水培养、药敏情况及预后等。结果肝硬化并自发性腹膜炎的发病率30.95%,临床表现以发热、腹痛为主要表现,而典型的腹膜刺激征仅见于约半数的患者。外周血白细胞升高者也不多见,但绝大多数患者外周血中性粒细胞分类升高,
2、腹水白细胞及PMN明显升高。腹水培养阳性率低,大肠杆菌和其他革兰阴性杆菌为主要致病菌,药物敏感试验对第3代头孢菌素药物敏感。合并SBP患者死亡率明显高于无SBP患者。结论乙型肝炎肝硬化合并SBP临床表现大多数不典型,PMN计数是诊断SBP的重要指标,头孢菌素类抗生素是乙型肝炎肝硬化并发SBP患者的首选抗生素。关键词:乙型肝炎肝硬化;自发性细菌性腹膜炎;诊断;治疗中图分类号:R512.62;R572.2文献标识码:A文章编号:16718348(2009)18233602Clinicalanalysisof52casesofhepatitisBvi
3、rusrelatedlivercirrhosiswithspontaneousbacterialperitonitisZENGLingyong,HEZhibing,YUANXiaoling(DepartmentofGastroenterology,NeijiangThirdPeoplesHospital,Neijiang641000,China)Abstract:ObjectiveToinvestigatetheclinicalcharacteristicsofhepatitisBvirusrelatedlivercirrhosiswithsp
4、ontaneousbacterialperitonitis(SBP).MethodsTheclinicalcharacteristics,laboratorytestresults,asciticcultureresults,drugssensitivitytestandprognosisof52patientswithhepatitisBvirusrelatedlivercirrhosiswithSBPwereanalyzedretrospectively.ResultsTheincidenceofSBPinlivercirrhosiswas3
5、0.95%.Mainclinicalmanifestationswerefeverandabdominalpain,andabouthalfofthepatientshadthetypicalperitonealirritation.Thepatientswithelevatedperipheralwhitebloodcells(WBC)wereafew,andthepatientswithelevatedneutrophilsinperipheralblood,WBCandpolymorphonuclearleucocyte(PMN)inascit
6、esweremost.Positiverateofasciticculturewaslow.E.coliandotherGramnegativebacilliweremainpathogens,andthirdgenerationcephalosporinwassensitiveindrugsusceptibilityassay.MortalityinthepatientswithSBPwassignificantlyhigherthanthatinthepatientswithoutSBP.ConclusionTheclinicalmanife
7、stationsofhepatitisBvirusrelatedlivercirrhosiswithSBPisatypical.PMNcountisanimportantindicatorofSBPdiagnosis.CephalosporinsisthepreferredantibioticsinthetreatmenthepatitisBvirusrelatedlivercirrhosiswithSBP.Keywords:hepatitisBcirrhosis;spontaneousbacterialperitonitis;diagnosis;t
8、reatment自发性细菌性腹膜炎(spontaneousbacterialperiton
