重症病毒性肝炎并发自发性细菌性腹膜炎临床特点分析

Clinical Characteristics of Spontaneous Bacterial Peritonitis(SBP) in Patients with Severe Type of Viral Hepatitis

目的 探讨重症病毒性肝炎 (重肝 )并发自发性细菌性腹膜炎 (SBP)的临床特点。方法 对 12 0例重肝并发SBP患者临床表现作一回顾性分析。结果 发热 10 2例 (85 .0 % ) ,腹痛 5 2例 (4 3.3% ) ,腹部压疼 6 2例 (5 1.6 % ) ,76例 (6 3.3% )腹水白细胞总数 (WBC) <0 .5× 10 9/ L ,10 2例 (85 .0 % )多核粒细胞 (PMN )相对值≥ 0 .5 0 ,2 4.2 %患者腹水细菌培养阳性 ,共分离细菌 35株 ,大肠埃希菌占菌株种类的 42 .9%。结论 重肝并发 SBP患者临床表现不典型 ,腹水 WBC多数低于诊断标准 ,病原菌以大肠埃希菌为主 ,腹水 PMN相对值是诊断

OBJECTIVE To investigate clinical characteristics of spontaneous bacterial peritonitis(SBP) in patients with severe type of viral hepatitis.METHODS A retrospective review of 120 cases of SBP associated with severe type of viral hepatitis was performed.RESULTS Clinical manifestations were as follows:fever 85.0%,abdominal tenderness 51.6%. 63.3% of the total white blood cells count in the ascitic fluid under 0.5×10 9 /L,85.0% of polymorphonuclear cell ratio above 0.50.The positive culture of the ascitic fluid 24.2%,whereas 42.9% of the isolated microorganisms were Escherichia coli.CONCLUSIONS Clinical manifestations in SBP may be non specific or absent.The total white blood cells count in the ascitic fluid are often under criteria for diagnosis.E.coli was the most common culture isolate.PMN ratio is the reliable parameter for the diagnosis of SBP.