摘要
目的 :探讨 5 2例肝硬变腹水并自发性细菌性腹膜炎的诊断与治疗。方法 :对 5 2例患者的临床表现、实验室检查及治疗措施进行分析。结果 :5 2例中有急性起病 2 8例 ,隐匿性起病 2 4例 ,抽出血性腹水 10例 ,脓性腹水 2例 ,腹水检查白细胞计数 >0 .3× 10 9/L 者 30例 ,多形核白细胞数 >5 0 %者 2 5例 ,腹水细菌培养阳性 6例。治疗中采用静脉滴注加腹腔注入抗生素 19例 ,有效 10例 ,无效 3例 ,死亡 6例。疗效与单纯静脉滴注组相比 ,P<0 .0 5 ,有显著差异。结论 :由于此病死亡率高 ,而腹水细菌培养阳性率又低 ,因此腹水白细胞数和多形核白细胞数的检测有较高的诊断价值。故临床上不应坐等腹水细菌培养结果 ,而应尽早进行综合治疗及采用静脉滴注加腹腔注入抗生素 。
Objective:To investigate the diagnosis and treatment of cirrhosis with ascites and spontaneous bacterial peritonitis in 52 patients.Methods:To analysis 52 cases clinical manitestation laboratory examination and treatment.Result:Among these cases, there were 28 sudder onset,24(46.2%) latent onset.To analysis 12 patients’s ascites,10 were bloody and 2 were purulent.30 cases whitecell counts were higher than 0.3×109/L and 25 patients percent of polymorphonuclear were higher than 50%. 6 patients bacterial culture in ascites showed positive.19 cases were treated by intravenous drip adding intra-abdominal antibiotic,10 were effective,3 showed ineffective and 6 were dead.The curative effect showed more evaluable than intravenous simple.Conclusions:Sincelthe lower postive rate of bacterial culture and higher mortality,the detection of the whitecell and polymorphonnclear showed valuable in clinical diagnosis.So the first and best way of treatment is using intravenous drip adding intra-abdominal antibiotic and complex treatment,not waiting for the result of the bacterial culture.The purpose was to reduce the mortality.
出处
《山西临床医药》
2000年第7期494-495,共2页
Shanxi Clinical Medicine
