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[目的]探讨肝硬化合并自发性细菌性腹膜炎(SBP)的临床诊断标准及病原菌分布特点。[方法]以肝硬化合并SBP腹水细菌培养阳性的患者共65例为观察对象,进行细菌培养、鉴定和耐药性试验。[结果]细菌培养共分离出细菌30株,其中革兰阴性菌16株(53.3%),革兰阳性菌11株(36.7%),其他菌3株;革兰阴性菌对三代头孢菌素的耐药率达40%以上,革兰阳性菌三代头孢菌素与青霉素都有较高的耐药率。[结论]诊断SBP除应尽早进行腹水培养外,还要结合临床症状,依据耐药报告结果合理选用抗菌药物。
[Objective] To investigate the clinical diagnostic criteria and distribution of pathogenic bacteria in cirrhotic patients with spontaneous bacterial peritonitis (SBP). [Method] A total of 65 patients with cirrhosis and SBP ascites bacterial culture positive were selected as experimental subjects for bacterial culture, identification and drug resistance test. [Result] Thirty bacteria were isolated from the bacterial culture, of which 16 (53.3%) were Gram-negative bacteria, 11 (36.7%) were Gram-positive bacteria and 3 were other bacteria. Gram- Resistance rate of 40% or more, Gram-positive third-generation cephalosporins and penicillins have a higher resistance rate. [Conclusion] In addition to the diagnosis of SBP ascites should be as early as possible, but also with clinical symptoms, based on the results of drug resistance rational use of antimicrobial agents.