[1]郭建琼,程玲,刘洪利,等.163例慢性重型乙型病毒性肝炎合并自发性细菌性腹膜炎的临床分析[J].第三军医大学学报,2011,33(21):2240-2243.
 Guo Jianqiong,Cheng Ling,Liu Hongli,et al.Clinical analysis of 163 chronic severe viral hepatitis B patients complicated with spontaneous bacterial peritonitis[J].J Third Mil Med Univ,2011,33(21):2240-2243.
点击复制

163例慢性重型乙型病毒性肝炎合并自发性细菌性腹膜炎的临床分析(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
33卷
期数:
2011年第21期
页码:
2240-2243
栏目:
论著
出版日期:
2011-11-15

文章信息/Info

Title:
Clinical analysis of 163 chronic severe viral hepatitis B patients complicated with spontaneous bacterial peritonitis
作者:
郭建琼 程玲刘洪利张长江蒋黎毛青
第三军医大学西南医院全军感染病研究所;泸州医学院附属医院感染病科
Author(s):
Guo Jianqiong Cheng Ling Liu Hongli Zhang Changjiang Jiang Li Mao Qing
Institution of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, 400038;Department of Infectious Diseases,  Affiliated Hospital of Luzhou Medical College ,Luzhou, Sichuan Province, 646000, China
关键词:
慢性重型乙型病毒性肝炎自发性细菌性腹膜炎临床分析
Keywords:
chronic severe viral hepatitis Bspontaneous bacterial peritonitisclinical analysis
分类号:
R512.62;R572.2
文献标志码:
A
摘要:
目的    探讨慢性重型乙型病毒性肝炎合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)临床特点,以提高疗效和改善预后。    方法      回顾性分析我科2008年1月至2010年12月住院的慢性重型乙型病毒性肝炎患者400例,合并SBP患者163例,男性137例,女性26例,年龄(44.21±11.30)岁。观察临床表现、血液检查、腹腔积液常规及细菌培养等情况,根据药敏及临床经验予抗生素治疗,观察疗效及转归因素分析。    结果      163例慢性重型乙型病毒性肝炎合并SBP患者主要表现腹部压痛(75.46%)、腹胀(61.35%)、腹痛(52.15%)、反跳痛(47.24%),主要并发症为肝性脑病(30.06%)、肾功能不全(19.63%),少数表现为消化道出血、休克、发热。腹腔积液白细胞数和中性粒细胞比例升高者分别为17.79%(29/163)和16.56%(27/163);腹腔积液或血液细菌培养阳性率分别仅为2.35%或23.53%,几乎为革兰染色阴性杆菌。慢性重型乙型病毒性肝炎合并SBP的住院期间死亡率为4.29%,除外自动出院患者,其住院期间死亡率上升至15.56%,治愈率84.44%。年龄、肝性脑病、肾功能不全、总胆红素、凝血酶原时间在治愈组和无效组中存在统计学差异(P<0.05)。    结论      慢性重型乙型病毒性肝炎合并SBP患者的临床表现不典型,及时、经验性抗感染治疗可提高患者治愈率。
Abstract:
Objective      To study the clinical features of chronic severe viral hepatitis B patients complicated with spontaneous bacterial peritonitis (SBP) to improve the therapeutic effect and prognosis.     Methods      A total of 400 inpatients with chronic severe viral hepatitis B in our department from Jan. 2008 to Dec. 2010 were enrolled. Retrospective data from the clinical records of 163 consecutive episodes of SBP were selected, including 137 men and 26 women with an average age of 44.21±11.30. Clinical manifestations, blood routine, ascites routine and bacterial culture of the patients were examined. The patients were treated with antibiotics based on the drug sensitivity test and clinical experience. The therapeutic effect and prognosis were further evaluated.      Results      The main clinical manifestations of the 163 patients comprised abdominal tenderness (75.46%), abdominal distension (61.35%), abdominal ache (52.15%) and rebound tenderness (47.24%). The main complications were hepatic encephalopathy (30.06%), and renal dysfunction (19.63%). The uncommon clinical manifestations were gastrointestinal hemorrhage, shock and fever. The ascending rates of white blood cell count and neutrophilic granulocyte ratio in ascites were 17.79% (29/163) and 16.56% (27/163), respectively. The positive rates of bacterial culture in ascites and in peripheral blood were 2.35% and 23.53%, respectively. Almost all the bacteria were Gram-negative bacillus. The death rate of chronic severe viral hepatitis B complicated with SBP was 4.29% during hospital. Except for automatic discharge, the death rate was up to 15.56% and the curative rate was 84.44%. Age, liver encephalopathy, abnormal renal function, total bilirubin and prothrombin time (P<0.05) are significance in two groups.    Conclusion      Chronic severe viral hepatitis B patients complicated with (SBP).  Early diagnosis and timely and experiential anti-infection treatment could improve the therapeutic effect.

参考文献/References:

郭建琼,  程玲, 刘洪利, 等. 163例慢性重型乙型病毒性肝炎合并自发性细菌性腹膜炎的临床分析[J].第三军医大学学报,2011,33(21):2240-2243.

相似文献/References:

[1]张南,夏杰,邓国宏,等.拉米夫定对慢性重型乙型肝炎患者生存率的提高[J].第三军医大学学报,2008,30(01):75.
 ZHANG Nan,XIA Jie,DENG Guo-hong,et al.Effect of lamivudine on survival rate of patients with chronic severe hepatitis B[J].J Third Mil Med Univ,2008,30(21):75.
[2]和振坤.肝硬化并发自发性腹膜炎患者90例临床分析[J].第三军医大学学报,2006,28(15):1631.
[3]李孟英,李玲,毛青.肾移植术后患者慢性重型乙型肝炎的分析及处理[J].第三军医大学学报,2005,27(12):1309.
[4]朱研,张辉艳,张长江,等.慢性肝衰竭并发自发性细菌性腹膜炎诊断标准探讨[J].第三军医大学学报,2011,33(21):2227.
 Zhu Yan,Zhang Huiyan,Zhang Changjiang,et al.Diagnostic criteria for spontaneous bacterial peritonitis in patients with chronic liver failure[J].J Third Mil Med Univ,2011,33(21):2227.
[5]朱剑功,王大刚,何叶莉,等.肝硬化合并自发性细菌性腹膜炎患者淋巴细胞亚群分析[J].第三军医大学学报,2014,36(18):1966.
[6]王瑞玲,梁后杰,刘俊康,等.自发性细菌性腹膜炎腹水中大肠杆菌潜生体增殖方式的研究[J].第三军医大学学报,2001,23(12):0.[doi:10.16016/j.1000-5404.2001.12.016 ]
 WANG Rui ling,LIANG Hou jie,LIU Jun kang,et al.[J].J Third Mil Med Univ,2001,23(21):0.[doi:10.16016/j.1000-5404.2001.12.016 ]
[7]张娟,孙伟,张维,等.血降钙素原联合中性粒细胞比例对肝病自发性细菌性腹膜炎的诊断意义[J].第三军医大学学报,2017,39(11):1159.
 Zhang Juan,Sun Wei,Zhang Wei,et al.Diagnostic value of serum procalcitonin level and neutrophil percentage in prediction of spontaneous bacterial peritonitis in patients with liver disease[J].J Third Mil Med Univ,2017,39(21):1159.

更新日期/Last Update: 2011-11-08