重症肝炎并发自发性细菌性腹膜炎的临床观察及护理

Observation and nursing on spontaneous bacterial peritonitis (SBP)in patients with severe viral hepatitis

目的探讨重症肝炎并发自发性细菌性腹膜炎(SBP)的观察方法及护理对策。方法对120例重症肝炎并发SBP患者临床特点及护理措施进行回顾性分析。结果临床表现为发热102例(85.0%),腹痛52例(43.3%),腹部压痛62例(51.6%)。SBP诱因依次为感染性腹泻23例(19.2%),上呼吸道感染19例(15.8%),泌尿系感染5例(4.2%),压疮2例(1.7%),原因不明71例(59.2%)。治愈好转30例(25.0%),恶化或无效90例(75.0%)。结论重症肝炎并发SBP临床表现不典型,病死率高。加强病情观察、积极预防肠道及上呼吸道感染、注重心理护理是提高生存率的重要护理措施。

Objectives To explore the effective observation methods and nursing strategies of spontaneous bacterial peritonitis（SBP） in patients with severe viral hepatitis.Methods A retrospective research of 120 cases of SBP associated with severe viral hepatitis was done.Results Clinical manifestations of the patients with SBP were various,which are fever（85.0%,102/120）,bellyache（43.3%,52/120）,and abdominal tenderness （51.6%,62/120）.The induced causes of SBP include infectious diarrhea（19.2%,23/120）,upper respiratory tract infection（15.8%,19/120）,urinary tract infection（4.2%,5/120）,bedsore（1.7%,2/120）,and unknown origin（59.2%,71/120）.Among 120 patients,30（25%） were cured or getting better,and 90（75%） were worsening or of no effect.Conclusions Clinical manifestations of the patients with SBP may be atypical or absent,so the mortality of these patients is high.Therefore,it is important to strengthen observation of state of the patient,prevent infection actively and pay attention to psychological nursing so as to increase viability of the patients with SBP.