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在慢性肝病和腹水病人中,自发性细菌性腹膜炎(SBP)的发生率高达12％。如果包括培养阴性病例,则可高达15％。在SBP治疗中,抗生素疗程多为经验性的,如Felisart等就采用待所有感染症状和体征消失后2天停药的方法。回顾性分析显示抗生素疗程平均为11.5(4～20)天。本文对33例SBP病人作前瞻性研究。对诊断明确的病例在抗生素治疗前及治疗开始后每二天作腹水多形核细胞(PMN)计数、细菌培养等检查。10例抗生素疗程由“经验”决定,23例则从腹水PMN计数≤250/mm~3作为停用抗生素的界值。 33例中腹水细菌培养阳性者15例,阴性者18例。两组初次腹水检查时平均PMN数分别为7515/mm~3
In patients with chronic liver disease and ascites, the incidence of spontaneous bacterial peritonitis (SBP) is as high as 12%. Up to 15% if culture-negative cases are included. In the treatment of SBP, the course of antibiotics are mostly empirical, such as Felisart and so on until all the symptoms and signs disappear 2 days after the withdrawal method. Retrospective analysis showed an average of 11.5 (4 to 20) days of antibiotic treatment. In this paper, 33 patients with SBP were prospectively studied. For diagnosed cases before the treatment of antibiotics and treatment started every two days for ascites polymorphonuclear cells (PMN) count, bacterial culture and other tests. The course of 10 antibiotics was decided by “experience”, and the 23 cases were used as cut-off antibiotic threshold from ascites PMN count ≤250 / mm ~ 3. In 33 cases of ascites bacterial culture were positive in 15 cases, negative in 18 cases. The average number of PMNs in the initial examination of ascites in both groups was 7515 / mm ~ 3 respectively