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[目的]观察酪酸梭菌二联活菌散联合头孢哌酮钠舒巴坦钠对肝硬化并发自发性腹膜炎患者的临床疗效以及安全评估。[方法]选择2015年3月~2017年1月我院治疗的自发性细菌性腹膜炎肝硬化患者108例。使用信封法将患者随机分为对照组和观察组,每组54例。对照组使用头孢哌酮钠舒巴坦钠,1.5g静脉滴注,1次/12h,14d为1疗程;观察组在对照基础上加用酪酸梭菌二联活菌散3袋/次,2次/d,14d为1疗程。ELISA法检测患者治疗前后血清炎性因子IL-6和TNF-α的变化。比较2组临床疗效和不良反应。[结果]治疗前2组IL-6和TNF-α表达差异无统计学意义(P>0.05),但治疗后观察组IL-6和TNF-α表达显著低于对照组(P<0.01)。观察组临床治疗有效率为88.9%(48/54),显著高于对照组的74.1%(40/54)(P<0.05)。观察组不良反应发生率为9.3%(5/54),对照组不良反应发生率为11.1%(6/54),2组差异无统计学意义(P>0.05)。[结论]酪酸梭菌二联活菌散联合头孢哌酮钠舒巴坦钠可以显著抑制肝硬化并发自发性腹膜炎患者的炎症反应,临床疗效显著,使用安全。
[Objective] To observe the clinical efficacy and safety evaluation of Clostridium butyricum combined with cefoperazone sodium and sulbactam sodium in patients with cirrhosis and spontaneous peritonitis. [Methods] A total of 108 patients with spontaneous bacterial peritonitis and cirrhosis were selected from March 2015 to January 2017 in our hospital. Patients using the envelope method were randomly divided into control group and observation group, 54 cases in each group. The control group was treated with cefoperazone sodium and sulbactam sodium 1.5g intravenously once a day for 12 hours and 14 days for one course of treatment. The observation group was treated with C. butyricum / , 14d for a course of treatment. The changes of serum inflammatory cytokines IL-6 and TNF-α before and after treatment were detected by ELISA. The clinical efficacy and adverse reactions in two groups were compared. [Results] There was no significant difference in the expression of IL-6 and TNF-α between the two groups before treatment (P> 0.05), but the levels of IL-6 and TNF-α in the observation group after treatment were significantly lower than those in the control group (P <0.01). The effective rate of clinical treatment in observation group was 88.9% (48/54), which was significantly higher than 74.1% (40/54) in control group (P <0.05). The incidence of adverse reactions in the observation group was 9.3% (5/54), and the incidence of adverse reactions in the control group was 11.1% (6/54). There was no significant difference between the two groups (P> 0.05). [Conclusion] Clostridium butyricum combined with cefoperazone sodium and sulbactam sodium can significantly inhibit the inflammatory reaction in cirrhotic patients complicated with spontaneous peritonitis. The clinical efficacy is significant and safe to use.