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目的 探讨预防性抗菌治疗对重型病毒性肝炎患者自发性细菌性腹膜炎 (SBP)的发生及疗效的影响。方法 12 0例重型病毒性肝炎患者随机分成 2组 ,治疗组 62例 ,入院后在综合护肝治疗的基础上 ,给予预防性抗菌治疗 ;对照组 5 8例 ,入院后仅给予综合护肝治疗。对两组患者SBP发生率、平均住院天数、存活率进行对比分析。结果 SBP的发生率治疗组 2 7 4% ( 17/62 ) ,对照组 44 8% ( 2 6/5 8) ,( χ2 =3 95 ,P <0 0 5 )。治疗组住院天数 ( 5 6 3± 2 4 2 )d ,对照组 ( 69 1± 2 6 1)d(t =2 79,P <0 0 1)。治疗组存活率 43 5 % ( 2 7/62 ) ,对照组 2 5 9% ( 15 /5 8) ( χ2 =4 12 ,P <0 0 5 )。结论 预防性抗感染治疗可降低重型病毒性肝炎SBP的发生率 ,缩短住院天数 ,提高存活率。
Objective To investigate the effect of preventive antibacterial therapy on the occurrence and efficacy of spontaneous bacterial peritonitis (SBP) in patients with severe viral hepatitis. Methods One hundred and twenty patients with severe viral hepatitis were randomly divided into two groups. The treatment group was given 62 cases. After admission, prophylactic antimicrobial therapy was given on the basis of comprehensive hepatoprotective therapy. In the control group, 58 cases were given only comprehensive hepatoprotective therapy . On the two groups of patients SBP incidence, the average length of stay in hospital, survival rates were analyzed. Results The incidence of SBP was 27.4% (17/62) in the treatment group and 44.8% (26/58) in the control group (χ2 = 955, P <0 05). The days of hospitalization in the treatment group were (563 ± 224) d, and the control group (69 1 ± 216) d (t = 2 79, P <0.01). Survival rate was 43.5% (27/62) in the treatment group and 25.9% (15/58) in the control group (χ2 = 4 12, P <0 05). Conclusion Prophylactic anti-infective therapy can reduce the incidence of severe viral hepatitis SBP, shorten the length of stay and improve the survival rate.