80例肝硬化腹水并发自发性细菌性腹膜炎高危因素分析

High risk factors for 80 cirrhotic ascites cases complicated with spontaneous bacterial peritonitis

目的探讨肝硬化腹水并发自发性细菌性腹膜炎（SBP）的高危因素，为临床早期预防提供依据。方法回顾分析我院2010年1月-2013年4月住院治疗140例肝硬化腹水患者，住院期间并发SBP80例为研究组，未发生SBP60例为对照组，比较两组患者的年龄、性别、既往SBP史、肝炎后肝硬化、上呼吸道感染、电解质紊乱、顽固性腹水、上消化道出血、肝性脑病、血清白蛋白、血清总胆红素、凝血酶原时间、C-反应蛋白、肝功能分级（Child-pugh）。并对这些因素进行统计学对比分析。结果两组患者的年龄、性别、上呼吸道感染、电解质紊乱、顽固性腹水、肝性脑病相比较差异无统计学意义（P〉0．05），研究组患者的既往SBP史、肝炎后肝硬化、上消化道出血、血清总胆红素、血清白蛋白、C-反应蛋白、凝血酶原时间及肝功能分级（Child-pugh）与对照组相比较差异均有统计学意义（P〈0．05）。结论既往SBP史、肝炎后肝硬化、上消化道出血、血清总胆红素、血清白蛋白、C-反应蛋白、凝血酶原时间、肝功能分级（Child-pugh）是肝硬化腹水患者并发SBP的独立高危因素，在临床诊疗过程中应高度重视。

Objective To analyze the high risk factors for cirrhotic ascites cases complicated with spontaneous bacterial peritonitis. Methods Retrospective analysis of our hospital in 2010 January to 2013 April 140 eases of cirrhotic patients with ascites hospitalized, During hospitalization patients with SBP80 as study group, non SBP60 patients in the control group, The two groups were comparable in age,gender,history of SBP,eirrhosis,upper respiratory tract infection,electrolyte disturbance,intractable ascites,upper gastrointestinal hemorrhage,hepatic encephalopathy,serum albumin,serum total bilirubin, prothrombin time, C-reactive protein,llver function classification （Child-pugh）, And these factors were statistically analyzed. Results The two groups in age,gender,upper respiratory tract infection,electrolyte disturbance,refractory ascites, hepatic encephalopathy compared with no statistical difference （P〉O.05）,The study group patients with SBP history, liver cirrhosis, upper gastrointestinal hemorrhage, serum total bilirubin, serum albumin, C - reactive protein and the grade of liver function,prothrombin time （Child-pugh）compared with control group,there was significant difference （P〈0.05）. Convlusions SBP history,liver cirrhosis,upper gastrointestinal hemorrhage,serum total bilirubin,serum albumin, C-reactive protein, prothrombin time,liver function classification （Child-pugh） is an independent risk factor in patients with cirrhosis ascites accompany SBP, In the process of clinical practice should pay attention to.