腹腔穿刺引流联合亚胺培南注射治疗肝硬化自发性腹膜炎的疗效观察

Clinical efficacy of abdominal paracentesis combined with imipenem injection in the treatment of spontaneous bacterial peritonitis in patients with liver cirrhosis

目的观察腹腔穿刺引流联合亚胺培南注射治疗肝硬化自发性腹膜炎的临床疗效。方法 62例肝硬化自发性腹膜炎患者按各自治疗意愿分成治疗组(32例)和对照组(30例),对照组采用腹腔穿刺引流及静脉注射亚胺培南治疗,治疗组在对照组基础上加用腹腔注射亚胺培南治疗,两组疗程均为7 d。治疗结束后观察两组治疗效果及临床症状体征变化。结果治疗组治疗总有效率(75.0%)和病死率(9.4%)明显优于对照组治疗总有效率(60.0%)和病死率(20.0%)(P<0.05);治疗组患者治疗后临床症状体征缓解较对照组明显(P<0.05)。结论腹腔穿刺引流联合亚胺培南注射治疗肝硬化自发性腹膜炎疗效显著,可明显降低病死率,值得临床推广应用。

Objective To observe the clinical efficacy of abdominal paracentesis combined with imipenem injection in the treatment of spontaneous bacterial peritonitis in patients with liver cirrhosis.Methods Sixty-two liver cirrhosis patients with spontaneous bacterial peritonitis were divided into treatment group（32 cases） and control group（30 cases）.Control group was treated with abdominal paracentesis and intravenous imipenem;in addition to the treatment of control group,the treatment group was treated with intraperitoneal injection of imipenem.The treatment time was 7 days in both groups.The clinical efficacy,clinical symptoms and signs in two groups were observed after treatment.Results Compared with control group,the total efficiency（75.0% vs.60.0%） was significantly increased（P〈0.05） and the mortality rate（9.4% vs.20%） were significantly decreased in treatment group（P〈0.05）;the clinical symptoms and signs in treatment group were also relieved significantly（P〈0.05）.Conclusion Abdominal paracentesis combined with imipenem injection is effective and significantly reduces mortality in the treatment of spontaneous bacterial peritonitis in patients with liver cirrhosis.