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目的探讨肝硬化合并自发性细菌性腹膜炎(SBP)的临床特点。方法于2001年6月至2005年6月回顾性分析112例确诊为肝硬化合并自发性细菌性腹膜炎(SBP)的临床资料。结果 112例患者均为不同程度发热,腹痛,腹部压痛,反跳痛.从轻微症状到典型腹膜炎表现。其中93例(83%)腹水多形核WBC(PMN)比值≥0.5,57例腹水细菌培养阳性(50.9%),病原菌以革兰阴性杆菌为主。其中大肠埃希菌为主要致病菌,药物敏感试验对第3代头孢菌素和第3代氟喹诺酮类药物敏感。结论肝硬化合并 SBP 的临床表现大多数不典型,腹水 PMN 比值是诊断 SBP 重要而可靠的指标;病原菌以大肠埃希菌为主,抗感染治疗首选第3代头孢菌素和第3代氟喹诺酮类药物。
Objective To investigate the clinical features of cirrhotic patients complicated with spontaneous bacterial peritonitis (SBP). Methods From June 2001 to June 2005, 112 patients with confirmed cirrhosis and spontaneous bacterial peritonitis (SBP) were retrospectively analyzed. Results All the 112 patients had fever, abdominal pain, abdominal tenderness and rebound tenderness, ranging from slight symptoms to typical peritonitis. 93 cases (83%) of ascites polymorphonuclear WBC (PMN) ratio of 0.5, 57 cases of ascites bacterial culture positive (50.9%), the pathogen mainly Gram-negative bacilli. Which Escherichia coli as the main pathogens, drug sensitivity tests on the third generation cephalosporins and third-generation fluoroquinolones sensitive. Conclusions Most of the clinical manifestations of liver cirrhosis complicated with SBP are not typical, the ascites PMN ratio is an important and reliable indicator of the diagnosis of SBP; Escherichia coli-based pathogens, anti-infective treatment of choice for third-generation cephalosporins and third-generation fluoroquinolones Drugs.