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目的:探讨肝硬化并发自发性细菌性腹膜炎(SBP)的早期诊断指标。方法:汇总分析我院近3年住院肝硬化并发SBP 303例腹腔积液细菌培养阳性者的实验诊断资料和临床特征,寻求早期诊断信息。结果:感染革兰阴性菌192例(63.4%),革兰阳性菌111例(36.6%)。革兰阴性菌感染腹腔积液白细胞计数>250×106/L者140例(46.2%),多形核白细胞(PMN)>0.25者143例(47.2%),革兰阳性菌感染者则为38例(12.5%)及34例(11.2%);两者比较,差异非常显著(P<0.01)。革兰阴性菌对亚胺培南、阿米卡星、头孢美唑、头孢吡肟、头孢哌酮和舒巴坦等敏感率较高;革兰阳性菌对替考拉宁、万古霉素、头孢吡肟和头孢唑啉等敏感率较高。结论:肝硬化并发SBP感染以革兰阴性菌为主,应根据细菌种类及药敏结果正确选用治疗药物。
Objective: To explore the early diagnosis of cirrhosis complicated with spontaneous bacterial peritonitis (SBP). Methods: The diagnostic data and clinical features of 303 cases of hospitalized cirrhotic patients with SBP in 303 cases with positive bacterial culture of ascites were collected and analyzed in order to seek the early diagnosis information. Results: 192 cases (63.4%) of Gram-negative bacteria and 111 (36.6%) Gram-positive bacteria were infected. Gram-negative bacteria were found in 140 cases (46.2%) with ascites leukocyte count> 250 × 106 / L, 143 cases (47.2%) with polymorphonuclear leukocytes (PMN)> 0.25 and 38 Cases (12.5%) and 34 cases (11.2%). The difference between the two groups was significant (P <0.01). Gram-negative bacteria to imipenem, amikacin, cefmetazole, cefepime, cefoperazone and sulbactam and other high sensitivity; Gram-positive bacteria on teicoplanin, vancomycin, Cefepime and cefazolin and other high sensitivity. CONCLUSIONS: Gram-negative bacteria are the main cause of cirrhosis complicated with SBP infection. The correct selection of therapeutic drugs should be based on the bacterial species and drug susceptibility results.