重型病毒性肝炎并发院内自发性细菌性腹膜炎的临床分析

Clinical analysis of nosocomial spontaneous bacterial peritonitis in patients with severe viral hepatitis

目的 :探讨重型病毒性肝炎患者院内自发性细菌性腹膜炎 (SBP)的特点及其防治对策。方法 :回顾性调查分析 1999年 1月至 2 0 0 1年 9月住院的重型病毒性肝炎患者院内 SBP的发生率、病死率及与其他部位感染、并发症的关系。 结果 :139例重型病毒性肝炎患者中共发生院内 SBP6 1例 (4 3.88%) ,死亡 36例 (5 9.0 2 %) ,其中发生 2例次以上的院内 SBP者有 2 2例 ,死亡 17例 (77.2 7%) ;出现院内 SBP者常先后或同时伴有其他部位感染 ,特别是口腔感染及肺部感染较为常见 ,肝性脑病、上消化道出血及肝肾综合征的发生率亦较高。 结论 :重型病毒性肝炎发生院内 SBP的比例较高 ,常与其他部位感染及并发症共存 ,病死率高。预防和治疗院内 SBP需要采取综合措施。

Objective: To study the clinical features and the preventive measures for nosocomial spontaneous bacterial peritonitis(SBP) in patients with severe viral hepatitis. Methods: The prevalence, motality, infection and complications were retrospectively studied in 139 patients with severe viral hepatitis from 1999 to 2001. Results: Sixty-one of 139(43.88%) patients got nosocomial SBP and 36 of them died(59.02%). Twenty-two patients got nosocomial SBP twice and 17 of them died (77.27%). Patients with SBP often had other site infection, especially in mouth and pulmonary. The incidence of hepatic coma, hemorrhage of upper digestive tract and hepatorenal syndrome were higher in the patients with SBP than those without. Conclusion: Nosocomial SBP is a common complication in patients with severe viral hepatitis. Comprehensive measures are necessary for the prevention of this complication.