肝硬化合并自发性细菌性腹膜炎48例临床分析

Cirrhosis complicated with spontaneous bacterial peritonitis:Clinical analysis of 48 cases

目的:探讨引起肝硬化并发自发性细菌性腹膜炎的相关因素和影响其预后的因素,为临床治疗与预防提供参考。方法:96例肝硬化患者分为无自发性细菌性腹膜炎组(对照组)和自发性细菌性腹膜炎组(观察组),每组48例,对其相关因素以及观察组预后情况进行分析。结果:观察组消化道出血(χ2=8.421,P=0.020)、肠道感染史(χ2=3.221,P=0.048)、血清总胆红素<10 g/L(χ2=20.214,P=0.000)、腹水总蛋白数>51μmol/L患者(χ2=15.215,P=0.000)的比例明显高于对照组(P<0.05～0.01);观察组治疗后,有效30例,无效18例,总有效率为62.5%,治疗有效患者并发肝性脑病、消化道出血发生率明显低于治疗无效患者(P<0.01)。结论:肝硬化合并自发性细菌性腹膜炎的发生与血清总胆红素与腹水总蛋白数有很大关系,其预后与肝性脑病、消化道出血存在一定关系,应针对上述情况进行正确治疗,积极预防影响因素。

Objective： To investigate the related factors of cirrhosis that is complicated with spontaneous bacterial peritonitis,and factors related to its prognosis.Methods： A total of 96 patients with cirrhosis Including 48 cases that were complicated with spontaneous bacterial peritonitis（observation group） and 48 simple cirrhosis cases（control group）.Correlated factors and prognosis of the two groups were observed and compared.Results： In the observation group,there was significant larger number of patients that showed gastrointestinal bleeding,intestinal infections,decreased serum total bilirubin and increased total protein in ascites comparing with the control group（P0.05～0.01）.Treatment was effective on 30 of the 48 cases in the observation group,while not effective on the rest18 cases showing total effective rate was 62.5%,besides;for those showed no effects had higher incidence of hepatic encephalopathy,gastrointestinal bleeding（P0.01）.Conclusion： The onset of cirrhosis complicated with spontaneous bacterial peritonitis is correlated with serum total bilirubin,total protein number,and its prognosis is related with complications of hepatic encephalopathy,gastrointestinal bleeding.Thus,proper measures for those complications can help to prevent its onset or improve the prognosis.