中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2013年
35期
20-21
,共2页
肝硬化%自发性腹膜炎%临床分析
肝硬化%自髮性腹膜炎%臨床分析
간경화%자발성복막염%림상분석
Liver cirrhosis%Spontaneous bacterial peritonitis%Clinical analysis
目的：探讨延边地区肝硬化并发自发性细菌性腹膜炎(SBP)临床特点。方法回顾性分析延边大学附属医院2008年1月~2012年12月在本院住院的198例肝硬化并发SBP患者临床资料。结果发热77例(38.9%),腹膜刺激征101例(51.0%),压痛20例(10.1%),血白细胞高102例(51.5%),血中性粒细胞百分比高165例(83.3%)；腹水培养结果为大肠埃希菌3例(3/5),腹水细菌培养阳性率3.68%；并发肝性脑病39例,电解质紊乱36例,上消化道出血29例,肝肾综合征25例；治愈者126例(63.6%),好转26例(13.1%),死亡32例(16.2%),死于肝肾综合征11例(34.4%),上消化道出血10例(31.2%),肝性脑病8例(25%),感染性休克3例(9.4%),14例自动出院。结论临床表现多不典型,血中性粒细胞百分比升高较多见,诊断需靠腹水检查；治疗药物首选第三代头孢菌素,疗程为7~14 d,同时给予保肝,输白蛋白或输血浆,利尿,必要时行腹腔冲洗术及腹腔内注入消炎药物。
目的：探討延邊地區肝硬化併髮自髮性細菌性腹膜炎(SBP)臨床特點。方法迴顧性分析延邊大學附屬醫院2008年1月~2012年12月在本院住院的198例肝硬化併髮SBP患者臨床資料。結果髮熱77例(38.9%),腹膜刺激徵101例(51.0%),壓痛20例(10.1%),血白細胞高102例(51.5%),血中性粒細胞百分比高165例(83.3%)；腹水培養結果為大腸埃希菌3例(3/5),腹水細菌培養暘性率3.68%；併髮肝性腦病39例,電解質紊亂36例,上消化道齣血29例,肝腎綜閤徵25例；治愈者126例(63.6%),好轉26例(13.1%),死亡32例(16.2%),死于肝腎綜閤徵11例(34.4%),上消化道齣血10例(31.2%),肝性腦病8例(25%),感染性休剋3例(9.4%),14例自動齣院。結論臨床錶現多不典型,血中性粒細胞百分比升高較多見,診斷需靠腹水檢查；治療藥物首選第三代頭孢菌素,療程為7~14 d,同時給予保肝,輸白蛋白或輸血漿,利尿,必要時行腹腔遲洗術及腹腔內註入消炎藥物。
목적：탐토연변지구간경화병발자발성세균성복막염(SBP)림상특점。방법회고성분석연변대학부속의원2008년1월~2012년12월재본원주원적198례간경화병발SBP환자림상자료。결과발열77례(38.9%),복막자격정101례(51.0%),압통20례(10.1%),혈백세포고102례(51.5%),혈중성립세포백분비고165례(83.3%)；복수배양결과위대장애희균3례(3/5),복수세균배양양성솔3.68%；병발간성뇌병39례,전해질문란36례,상소화도출혈29례,간신종합정25례；치유자126례(63.6%),호전26례(13.1%),사망32례(16.2%),사우간신종합정11례(34.4%),상소화도출혈10례(31.2%),간성뇌병8례(25%),감염성휴극3례(9.4%),14례자동출원。결론림상표현다불전형,혈중성립세포백분비승고교다견,진단수고복수검사；치료약물수선제삼대두포균소,료정위7~14 d,동시급여보간,수백단백혹수혈장,이뇨,필요시행복강충세술급복강내주입소염약물。
Objective To probe the clinical features of liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP) in Yanbian area. Methods Retrospective analysis of the Yanbian University Hospital's 198 patients with the cases of liver cirrhosis complicated with SBP in period of 2008~2012. Results 77 cases of fever (38.9%), peritoneal irritation sign in 101 cases (51%), 20 cases of tenderness (10.1%), high white blood cells in 102 cases(51.5%), neutrophil percent higher in 165 cases (83.3%);the results of ascites were escherichia coli (3/5) in 3 cases, ascites bacterial culture positive rate was 3.68%;39 cases complicated with hepatic encephalopathy, electrolyte disorder in 36 cases, 29 cases of upper gastrointestinal bleeding, 25 cases of hepatorenal syndrome;126 cases were cured (63.6%), improved in 26 cases (13.1%), death of 32 cases (16.2%), died of hepatorenal syndrome in 11 cases (34.4%), 10 cases of upper gastrointestinal bleeding (31.2%), 8 cases with hepatic encephalopathy (25%), 3 cases of septic shock (9.4%), 14 cases of discharge. Conclusion Atypical clinical manifestations, most of the higher percentage blood neutrophils, diagnosis needs to rely on the ascites; preferred drug is the third generation cephalosporins, treatment for 7~14 days, while liver protection, supplementation of albumin or plasma, diuresis, if necessary, do the peritoneal lavage and intraperitoneal injection of anti-inflammatory drugs.
