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【答】培养阴性的中性粒细胞性腹水(GNNA)是指症状、腹水性质和外周血象改变均符合自发性细菌性腹膜炎(SBP),但细菌培养阴性。出现这种腹水的腹膜炎称为自发性腹膜炎,不作自发性细菌性腹膜炎看待,但应进行处理。CNNA是全身性细菌感染的一个局部表现,采用血培养瓶床旁接种腹水法(血瓶法)可提高致病菌的阳性检出率。抗菌治疗后腹水绝对多形核细胞减少至正常。CNNA是自发性细菌性腹膜炎的一种变异,其诊断标准为:(1)腹水致病菌培养阴性;(2)绝对多形核细胞≥0.5×10~9/L;(3)无腹腔内感染灶;(4)7d内未用抗菌药物;(5)能排除其他原因(如腹腔出血、胰腺炎、结核、腹膜癌等)。出现GNNA的原因有(1)传统培养方法的敏感性较低(30%～70%);(2)低菌性
[A] Cultured negative neutrophilic ascites (GNNA) is defined as symptoms, ascites and peripheral blood changes that are consistent with spontaneous bacterial peritonitis (SBP) but negative for bacterial culture. Peritonitis with this ascites is called spontaneous peritonitis and is not treated for spontaneous bacterial peritonitis but should be treated. CNNA is a localized manifestation of systemic bacterial infection. Ascites fluid test (blood-flask method) can improve the positive detection rate of pathogenic bacteria. Ascites absolute polymorphonuclear cells decreased to normal after antibacterial treatment. CNNA is a variant of spontaneous bacterial peritonitis whose diagnostic criteria are: (1) culture of ascites pathogens negative; (2) absolute polymorphonuclear cells ≥ 0.5 × 10 ~ 9 / L; (3) no intraperitoneal (4) 7d without antibacterial drugs; (5) can rule out other causes (such as abdominal bleeding, pancreatitis, tuberculosis, peritoneal cancer, etc.). The reasons for the presence of GNNA are: (1) the sensitivity of traditional culture methods is low (30% to 70%); (2)