预防性应用抗生素防治慢性重型肝炎患者自发性细菌性腹膜炎发生

The clinical observation on prophylactic antiseptic therapy in chronic severe hepatitis patients

目的探讨应用抗菌药物在防治慢性重型肝炎并发自发性细菌性腹膜炎的作用。方法84例慢性重型肝炎住院患者,随机分为治疗组和对照组,两组病例在入院前1周未经抗菌治疗、入院时无感染征象、住院时间均超过72h,在采用积极保肝、营养支持的基础上,治疗组52例采用预防性应用抗生素(头孢噻肟钠),对照组均未预防性应用任何抗菌药物。结果治疗组预防性应用抗菌药物发生自发性细菌性腹膜炎12例(23%),死亡率为37.5%;对照组发生感染17例(53.1%),死亡率为50%;治疗组SBP发生率明显低于对照组(P<0.05),死亡率低于对照组(P<0.05)。结论预防性应用抗菌药物可以减少重型肝炎并发自发性细菌性腹膜炎的发生率,提高慢性重型肝炎的治愈率,改善预后。

Objective To observe the effects of prophylactic antiseptic therapy in patients with chronic severe hepatitis. Method 84 cases of chronic severe hepatitis were divided into two groups according to clinical stage and in 52 cases prophylactic antibiotics was used and in 32cases was not used. Results The spontaneous bacterial peritonitis occurred in 12 patients （23%） and the mortality rate was 37.5% in antibiotics group, while those were 53.1% and 50% in control（P 〈0.05）. Conclusion Prophylactic antiseptic treatment can reduce the incidence of SBP in patients with chronic severe hepatitits.