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作者对自1983年1月～1985年2月60例住院的腹水患者作腹水多形核白细胞计数、pH、乳酸盐浓度、动脉血pH和静脉血乳酸的单项和多项联合测定,对它们在腹水感染时即刻诊断的相对预测值进行评价.46例为肝硬化腹水,其中21例经肝活检病理证实.9例为恶性腹水,2例为心源性腹水,2例为肾性腹水,1例原因不明.腹水标本采集时,患者均未应用抗生素.检测项目为腹水:pH、乳酸盐、白细胞计数及分类、细胞学检查、蛋白、糖、LDH、淀粉酶,静脉血:乳酸、白细胞计数、肝功能及需氧与厌氧菌培养,动脉血:PH.结果:9例腹水由于细菌生长而确诊为感染性,其中5例为自发性腹膜炎,4例为继发性(3例胃肠道穿孔、1例肠系膜血栓形成).感染性腹水组中,pH平均值为7.20±0.19(范围6.75～7.38),与非感染组7.44±0.06(7.33～7.59)比较,有显著差异(p<0.05),仅1例感染性腹水
The author of 60 cases of hospitalized ascites patients from January 1983 to February 1985 ascites polymorphonuclear leukocyte count, pH, lactate concentration, arterial pH and venous blood lactate single and multiple joint determination of their The relative predictive value of immediate diagnosis of ascites infection was evaluated in 46 patients with cirrhosis and ascites, of which 21 were confirmed by liver biopsy, 9 as malignant ascites, 2 ascites, 2 as renal ascites, 1 case of unknown cause.Ascites samples collected, the patient did not use antibiotics.Assessment items ascites: pH, lactate, white blood cell count and classification, cytology, protein, sugar, LDH, amylase, venous blood: lactic acid, White blood cell count, liver function and aerobic and anaerobic cultures, arterial blood: PH.Results: 9 cases of ascites were diagnosed as infectious due to bacterial growth, 5 cases were spontaneous peritonitis and 4 cases were secondary (3 cases Gastrointestinal perforation, and 1 case of mesenteric thrombosis.) In the ascitic fluid group, the average pH was 7.20 ± 0.19 (range, 6.75-7.38), which was significantly different from 7.44 ± 0.06 (7.33-7.59) in the non-infected group p <0.05), only 1 case of infectious ascites