【摘要】：目的探討肝硬化腹水合并自發(fā)性細(xì)菌性腹膜炎(SBP)的病原學(xué)特點及危險因素。方法回顧性分析醫(yī)院2012年1月-2015年6月收治124例肝硬化腹水并發(fā)SBP患者的臨床資料,對患者的臨床表現(xiàn)、實驗室病原學(xué)檢查結(jié)果,同時對所有患者的臨床病理因素采用Logistic回歸分析,分析其發(fā)病的危險因素。結(jié)果患者主要表現(xiàn)包括發(fā)熱、腹脹、腹痛;124例患者中共有81例細(xì)菌培養(yǎng)結(jié)果為陽性,陽性率為65.32%,共檢出病原菌88株,其中革蘭陽性55株占62.50%,革蘭陰性菌31株占35.23%,真菌2株占2.27%;對患者的性別、年齡、臨床表現(xiàn)、是否合并有消化道出血、血常規(guī)WBC水平、腹水常規(guī)WBC水平、白蛋白水平進(jìn)行統(tǒng)計分析,經(jīng)單因素分析,血清白蛋白、腹水WBC、腹水白蛋白以及伴有消化道出血與SBP發(fā)生具有密切的關(guān)系(P0.05);經(jīng)過Logistic多因素回歸分析結(jié)果顯示,消化道出血和腹水蛋白是肝硬化腹水患者并發(fā)SBP的獨立危險因素(P0.05)。結(jié)論肝硬化腹水合并自發(fā)性細(xì)菌性腹膜炎患者主要為革蘭陽性菌感染導(dǎo)致,其中表皮葡萄球菌感染較為多見,患者腹水蛋白≤10g/L和消化道出血是發(fā)病的獨立危險因素。
[Abstract]:Objective to investigate the etiological characteristics and risk factors of cirrhotic ascites with spontaneous bacterial peritonitis (SBP). Methods the clinical data of 124 patients with cirrhotic ascites complicated with SBP from January 2012 to June 2015 were retrospectively analyzed. The clinicopathological factors of all patients were analyzed by Logistic regression analysis. Results the main manifestations of the patients included fever, abdominal distension and abdominal pain. Among 124 patients with abdominal pain, 81 cases were positive in bacterial culture, and the positive rate was 65.32. 88 strains of pathogenic bacteria were detected. Among them, 55 Gram-positive strains accounted for 62.50%, 31 Gram-negative bacteria accounted for 35.233,2.27.The gender, age, clinical manifestations, gastrointestinal bleeding, blood routine WBC level, and ascites routine WBC level were observed in the patients. The serum albumin, ascites WBC, ascites albumin and gastrointestinal bleeding were closely related to the occurrence of SBP by univariate analysis (P0.05), and the results of multivariate Logistic regression analysis showed that the serum albumin, ascitic fluid albumin in ascites and gastrointestinal bleeding were closely related to the occurrence of SBP (P0.05). Gastrointestinal hemorrhage and ascites protein were independent risk factors of SBP in patients with cirrhosis and ascites (P0.05). Conclusion the patients with cirrhosis and ascites with spontaneous bacterial peritonitis are mainly caused by Gram-positive bacteria infection, among which Staphylococcus epidermidis infection is more common. Ascites protein 鈮，

本文編號：2248520